Information Collection

Application Dividend Inquiry Letter

IC 197662 under ICR 201104-1505-008 · OMB 1505-0228.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0228 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TD F 102.1 Application Dividend Inquiry Letter	Form
TD F 102.1 Dividend Inquiry Report SBLF Dividends Inquiry v15_05-16-11_543pm.docx	Form

IC Title:

Application Dividend Inquiry Letter

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	TD F 102.1	Dividend Inquiry Report	SBLF Dividends Inquiry v15_05-16-11_543pm.docx		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Industry Sector Income Stabilization

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	83	83
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.