Standard Assurances form

OJP Standard Assurance form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0140 can be found here:

Documents and Forms

Document Name Document Type
Standard Assurances form Form and Instruction
Standard Assurances OJP_Standard_Assurances_(showing_3_4_2008_revision)_(2)[1].docx Form and Instruction
OJP Standard Assurances (showing 3 4 2008 revision) (2).pdf Standard Assurances IC Document
The change to standard assurances form.doc explanation for change IC Document
gms login screen.pdf GMS login screen shots IC Document

Information Collection (IC) Details

IC Title:	Standard Assurances form	Agency IC Tracking Number:	OGC/OCR

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	Standard Assurances	OJP_Standard_Assurances_(showing_3_4_2008_revision)_(2)[1].docx		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	1,000	-5,371	6,371
Annual IC Time Burden (Hours)	10,000	7,440	2,560
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Standard Assurances	OJP Standard Assurances (showing 3 4 2008 revision) (2).pdf	06/12/2008
explanation for change	The change to standard assurances form.doc	06/12/2008
GMS login screen shots	gms login screen.pdf	11/23/2009

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