Information Collection

Affected Public (State, Local, and Tribal Governments) (43 CFR Subpart 4120)

IC 178851 under ICR 201001-1004-001 · OMB 1004-0019.

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Documents and Forms

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IC Title:

Affected Public (State, Local, and Tribal Governments) (43 CFR Subpart 4120)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 43 CFR 4120

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

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 583

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	583	548	35
Annual IC Time Burden (Hours)	583	373	210
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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