Historic Preservation Certifications, 36 CFR Part 67

Forms and Documents

Document	Type	Status	Availability
Form 10-168 Historic Preservation Certification Application (HPCA) - Part I (Individuals)	Form and Instruction	Modified	Repair queued
Form 10-168c HPCA - Part 3 (private sector employing consultants)	Form and Instruction	New	Repair queued
Form 10-168c HPCA - Part 3 (individuals employing consultants)	Form and Instruction	New	Available
Form 10-168b HPCA - Amendments (private sector employing consultants)	Form and Instruction	New	Repair queued
Form 10-168b HPCA - Amendments (Individuals employing consultants)	Form and Instruction	New	Repair queued
Form 10-168a HPCA - Part 2 (private sector employing individuals)	Form and Instruction	New	Repair queued
Form 10-168a HPCA - Part 2 (Individuals employing consultants)	Form and Instruction	New	Available
Form 10-168 Historic Preservation Certification Application - Part I (private sector employing consultants)	Form and Instruction	New	Available
Form 10-168 Historic Preservation Certification Application - Part I (Individuals employing consultants)	Form and Instruction	New	Available
Form 10-168e State Review of HPCA Part 3	Form	New	Available
Form 10-168e State Review of HPCA Part 2	Form	New	Repair queued
Form 10-168d State Review of HPCA Part I	Form	New	Available
Form 10-168c HPCA - Part 3 (private sector)	Form and Instruction	Modified	Available
Form 10-168b HPCA - Amendments (private sector)	Form and Instruction	Modified	Available
Form 10-168a HPCA - Part 2 (private sector)	Form and Instruction	Modified	Available
Form 10-168c HPCA Part 3 (Individuals)	Form and Instruction	Modified	Repair queued
Form 10-168b HPCA Amendments (Individuals)	Form and Instruction	Modified	Repair queued
Form 10-168a HPCA - Part 2 ( Individuals)	Form and Instruction	Modified	Repair queued
Form 10-168 Historic Preservation Certification Application - Part I (private sector)	Form and Instruction	Modified	Repair queued
1024-0009 30-day FRN Published 03282013 2013-07137.pdf	Supplementary Document	Uploaded 2013-03-28	Available
1024-0009 Supporting Statement A - final rev.docx	Supporting Statement A	Uploaded 2013-07-22	Available
36CFR67.pdf	Supplementary Document	Uploaded 2013-03-06	Repair queued
1024-0009 60-day notice published.pdf	Supplementary Document	Uploaded 2013-03-06	Available
information collection.1024-0009.IRC sec170.pdf	Supplementary Document	Uploaded 2009-09-10	Available
information collection.1024-0009.IRC sec47.pdf	Supplementary Document	Uploaded 2009-06-23	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
43757	Historic Preservation Certification Application (HPCA) - Part I (Individuals)	Form and Instruction	Modified
206167	Certification of Historic Districts		New
206166	Certification of Statutes		New
206165	HPCA - Part 3 (private sector employing consultants)	Form and Instruction	New
206164	HPCA - Part 3 (individuals employing consultants)	Form and Instruction	New
206163	Appeals (private sector employing consultants)		New
206162	HPCA - Amendments (private sector employing consultants)	Form and Instruction	New
206161	HPCA - Amendments (Individuals employing consultants)	Form and Instruction	New
206157	HPCA - Part 2 (private sector employing individuals)	Form and Instruction	New
206156	HPCA - Part 2 (Individuals employing consultants)	Form and Instruction	New
206153	Historic Preservation Certification Application - Part I (private sector employing consultants)	Form and Instruction	New
206151	Historic Preservation Certification Application - Part I (Individuals employing consultants)	Form and Instruction	New
206061	Appeals (private sector)		New
206060	Appeals (individuals)		New
206059	State Review of HPCA Amendments		New
206058	State Review of HPCA Part 3	Form	New
206057	State Review of HPCA Part 2	Form	New
206056	State Review of HPCA Part I	Form	New
190590	HPCA - Part 3 (private sector)	Form and Instruction	Modified
190589	HPCA - Amendments (private sector)	Form and Instruction	Modified
190588	HPCA - Part 2 (private sector)	Form and Instruction	Modified
190587	HPCA Part 3 (Individuals)	Form and Instruction	Modified
190586	HPCA Amendments (Individuals)	Form and Instruction	Modified
190584	HPCA - Part 2 ( Individuals)	Form and Instruction	Modified
190549	Historic Preservation Certification Application - Part I (private sector)	Form and Instruction	Modified

ICR Details

OMB Control No: 1024-0009	ICR Reference No: 201301-1024-002
Status: Historical Active	Previous ICR Reference No: 200906-1024-002
Agency/Subagency: DOI/NPS	Agency Tracking No:
Title: Historic Preservation Certifications, 36 CFR Part 67
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/23/2013
	Date Received in OIRA: 03/28/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2016	36 Months From Approved	07/31/2013
Responses	9,848	0	5,578
Time Burden (Hours)	82,418	0	25,798
Cost Burden (Dollars)	11,497,474	0	7,001,644

---

Abstract: Sections 47 and 170(h) of the Internal Revenue Code require the Secretary of the Interior to certify to the Secretary of the Treasury whether (1) properties are historic structures, and (2) rehabilitation work on such properties is consistent with their historic character. These certifications are necessary for applicants to receive a Federal income tax credit for rehabilitation (sec. 47), or an income tax deduction for charitable contributions for conservation purposes (sec. 170(h)).

---

Authorizing Statute(s): US Code: 26 USC 170 Name of Law: Qualified Conservation Contributions
   US Code: 26 USC 47 Name of Law: Qualified Rehabilitated Buildings
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 52757	08/30/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 19006	03/28/2013
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 25

IC Title	Form No.	Form Name
HPCA - Part 2 ( Individuals)	10-168a	HPCA Part 2
HPCA - Part 2 (private sector)	10-168a	HPCA Part 2
HPCA - Amendments (private sector)	10-168b	HPCA Amendment
HPCA Amendments (Individuals)	10-168b	HPCA Amendment
Historic Preservation Certification Application - Part I (private sector)	10-168	HCPA Part 1
HPCA - Part 3 (private sector)	10-168c	HPCA Part 3
HPCA Part 3 (Individuals)	10-168c	HPCA Part 3
Historic Preservation Certification Application - Part I (Individuals employing consultants)	10-168	HPCA Part 1
HPCA - Part 2 (Individuals employing consultants)	10-168a	HPCA Part 2
HPCA - Part 2 (private sector employing individuals)	10-168a	HPCA Part 2
Appeals (private sector employing consultants)
HPCA - Part 3 (individuals employing consultants)	10-168c	HPCA Part 3
HPCA - Part 3 (private sector employing consultants)	10-168c	HPCA Part 3
Certification of Statutes
Certification of Historic Districts
State Review of HPCA Part I	10-168d	HPCA State Historic Preservation Office Review & Recommendation Sheet - Significance Part I
State Review of HPCA Part 2	10-168e	HPCA State Historic Preservation Office Review & Recommendation Sheet - Rehabilitation - Part 2/Part 3
State Review of HPCA Part 3	10-168e	HPCA State Historic Preservation Office Review & Recommendation Sheet - Rehabilitation - Part 2/Part 3
State Review of HPCA Amendments
Appeals (individuals)
Appeals (private sector)
Historic Preservation Certification Application - Part I (private sector employing consultants)	10-168	HPCA Part 1
HPCA - Amendments (Individuals employing consultants)	10-168b	HPCA Amendment
HPCA - Amendments (private sector employing consultants)	10-168b	HPCA Amendment
Historic Preservation Certification Application (HPCA) - Part I (Individuals)	10-168	HPCA Part 1

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	9,848	5,578	0	4,943	-673	0
Annual Time Burden (Hours)	82,418	25,798	0	16,296	40,324	0
Annual Cost Burden (Dollars)	11,497,474	7,001,644	0	271,889	4,223,941	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: We are estimating 9,848 responses, 82,418 annual burden hours, and $11,497,474 in nonhour burden costs, which is a net increase of 4,270 responses, 56,620 annual burden hours, and $4,485,830 for nonhour burden costs. We are reporting as program changes 4,943 responses totaling 16,296 annual burden hours and $271,889 in nonhour burden costs. These program changes are for requirements that were not included in our previous submissions: • State Review of Applications (Parts 1, 2, and 3) and Amendments • Appeals • Certification of Statutes • Certification of Historic Districts The remaining net decrease of 673 responses and net increase of 40,234 annual burden hours and $4,223,941 in nonhour burden costs are adjustments based on our experience in administering this collection and our outreach. Adjustments include reestimating number of responses and completion times, change in fees, and better accounting of other costs associated with submissions and use of consultants by respondents.

---

Annual Cost to Federal Government: $2,100,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/28/2013

---