Information Collection

1924-A - State, Local and Tribal Government

IC 191596 under ICR 200911-0575-002 · OMB 0575-0042.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0575-0042 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RD 1924-07 1924-A - State, Local and Tribal Government	Form
RD 1924-07 Contract Change Order 1924-07.pdf	Form
RD 1924-09 Certificate of Contractor's Release 1924-09.pdf	Form
RD 1924-10 Release by Claimants 1924-10.pdf	Form
RD 1924-12 Inspection Report 1924-12.pdf	Form
RD 1924-18 Partial Payment Estimate 1924-18.pdf	Form

IC Title:

1924-A - State, Local and Tribal Government

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	RD 1924-07	Contract Change Order	1924-07.pdf	Yes	No	Fillable Printable
Form	RD 1924-09	Certificate of Contractor's Release	1924-09.pdf	Yes	No	Fillable Printable
Form	RD 1924-10	Release by Claimants	1924-10.pdf	Yes	No	Fillable Printable
Form	RD 1924-12	Inspection Report	1924-12.pdf	Yes	No	Fillable Printable
Form	RD 1924-18	Partial Payment Estimate	1924-18.pdf	Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	14,896	14,896
Annual IC Time Burden (Hours)	4,661	4,661
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.