OGIS Request for Assistance and Consent

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3095-0068 can be found here:

Documents and Forms

Document Name Document Type
Form NA 10003 OGIS Request for Assistance and Consent Form and Instruction
OGIS Smart Instruction 9-10.doc Other-null
NA 10003 Consent to Make Inquiries and Release of Information and na-10003.doc Form and Instruction
NA 10004 Request for Assistance and Consent to Make Inquiries and na-10004.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	OGIS Request for Assistance and Consent	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA 10003	Consent to Make Inquiries and Release of Information and Records	na-10003.doc	No		Printable Only
Form and Instruction	NA 10004	Request for Assistance and Consent to Make Inquiries and Release of Information and Records	na-10004.doc	No		Printable Only
Other-null			OGIS Smart Instruction 9-10.doc	Yes	No	Printable Only

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	10	10
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.