Information Collection

Facilitiy License Standards

IC 182409 under ICR 201207-3141-010 · OMB 3141-0012.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3141-0012 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Facilitiy License Standards	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Mandatory

CFR Citation: 25 CFR 522

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: 75	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-75	75
Annual IC Time Burden (Hours)	-750	750
Annual IC Cost Burden (Dollars)	-13,125	13,125

Documents for IC

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