Application for Indemnification

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3135-0094 can be found here:

Documents and Forms

Document Name Document Type
Form 3135-0094 Application for Indemnification Form and Instruction
3135-0094 Arts and Artifacts Indemnity Program International Indem Application for Indemnity International Instructions Oct 2013.pdf www.arts.gov/grants/apply/Indemnity/indemnityinternational.html Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Indemnification	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 201

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3135-0094	Arts and Artifacts Indemnity Program International Indemnity	Application for Indemnity International Instructions Oct 2013.pdf	http://www.arts.gov/grants/apply/Indemnity/indemnityinternational.html	Yes	Yes	Fillable Fileable Signable

Line of Business: Education

Subfunction: Cultural and Historic Exhibition

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	2,233	2,233
Annual IC Cost Burden (Dollars)	90,000	90,000

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.