Information Collection

Outreach

IC 197171 under ICR 201105-1505-001 · OMB 1505-0233.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0233 can be found here:

Documents and Forms

Document Name Document Type
Screen shot 2011-06-02 at 4.41.36 PM.png Other-Screen Shot
Screen shot 2011-06-02 at 4.41.47 PM.png Other-Screen Shot
Screen shot 2011-06-02 at 4.44.03 PM.png Other-Screen Shot
Screen shot 2011-06-02 at 4.44.18 PM.png Other-Screen Shot
Screen shot 2011-06-02 at 4.45.11 PM.png Other-Screen Shot
Screen shot 2011-06-02 at 4.46.19 PM.png Other-Screen Shot
Screen shot 2011-06-02 at 4.46.27 PM.png Other-Screen Shot

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Outreach	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screen Shot	Screen shot 2011-06-02 at 4.41.36 PM.png	Yes	Yes	Fillable Fileable
Other-Screen Shot	Screen shot 2011-06-02 at 4.41.47 PM.png	Yes	Yes	Fillable Fileable
Other-Screen Shot	Screen shot 2011-06-02 at 4.44.03 PM.png	Yes	Yes	Fillable Fileable
Other-Screen Shot	Screen shot 2011-06-02 at 4.44.18 PM.png	Yes	Yes	Fillable Fileable
Other-Screen Shot	Screen shot 2011-06-02 at 4.45.11 PM.png	Yes	Yes	Fillable Fileable
Other-Screen Shot	Screen shot 2011-06-02 at 4.46.19 PM.png	Yes	Yes	Fillable Fileable
Other-Screen Shot	Screen shot 2011-06-02 at 4.46.27 PM.png	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: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	1,251	1,251
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.