Information Collection

Application for History of Timely Payments Determination (New 43 CFR 3474.10)

IC 207900 under ICR 201307-1004-003 · OMB 1004-0205.

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IC Title:	Application for History of Timely Payments Determination (New 43 CFR 3474.10)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 43 CFR 3474.10

Information Collection Instruments:

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

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3	Number of Respondents for Small Entity: 2

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3	3
Annual IC Time Burden (Hours)	24	24
Annual IC Cost Burden (Dollars)	480	480

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