Information Collection

Local Government Certification Application/Agreement

IC 11094 under ICR 201105-1024-001 · OMB 1024-0038.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0038 can be found here:

Documents and Forms

Document Name Document Type
36 CFR 61 attachment, 1024-0038.doc Procedures for State, Tribal, and Local Government Historic Preservation Programs; 36 CFR 61 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Local Government Certification Application/Agreement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 36 CFR 61

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 40 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	55	0	1	54
Annual IC Time Burden (Hours)	1,177	0	544	633
Annual IC Cost Burden (Dollars)	935	935	0	0

Documents for IC

Title	Document	Date Uploaded
Procedures for State, Tribal, and Local Government Historic Preservation Programs; 36 CFR 61	36 CFR 61 attachment, 1024-0038.doc	11/30/2007

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