Information Collection

State Appliance Rebate Program

IC 191613 under ICR 200912-1910-007 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Copy of Monthly Reporting Form_ApplianceRebate-new.xls	Other-spread sheet

IC Title:

Agency IC Tracking Number:

Jaime Carlson-Appliance

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-spread sheet			Copy of Monthly Reporting Form_ApplianceRebate-new.xls		Yes	No	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Resource Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	672	672
Annual IC Time Burden (Hours)	1,344	1,344
Annual IC Cost Burden (Dollars)	130,000	130,000

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.