Information Collection

Electronic Capability Statement

IC 189633 under ICR 200906-1505-002 · OMB 1505-0220.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0220 can be found here:

Documents and Forms

Document Name Document Type
capabilitystatement.pdf Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Electronic Capability Statement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			capabilitystatement.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Industry Sector Income Stabilization

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 420	Number of Respondents for Small Entity: 420

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	420	420
Annual IC Time Burden (Hours)	54	54
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.