Information Collection

Screening

IC 200507 under ICR 201112-3170-001 · OMB 3170-0018.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0018 can be found here:

Documents and Forms

Document Name Document Type
DDT Servicing Participant Screener 1-25-12.doc Other-Screener

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Screening	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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screener			DDT Servicing Participant Screener 1-25-12.doc		No		Printable Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 360	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	360	360
Annual IC Time Burden (Hours)	36	36
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.