Baseline Questionnaire for Certified Local Governments

Procedures for State, Tribal, and Local Government Historic Preservation Programs; 36 CFR 61

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0038 can be found here:

Documents and Forms

Document Name Document Type
Baseline Questionnaire for Certified Local Governments Form
National Park Service Cumulative Baseline Questionnaire Baseline Questionnaire Form for CLGs - 2014.doc www.nps.gov/history/hps/clg/index.htm Form

Information Collection (IC) Details

IC Title:	Baseline Questionnaire for Certified Local Governments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	None	National Park Service Cumulative Baseline Questionnaire for CLGs	Baseline Questionnaire Form for CLGs - 2014.doc	http://www.nps.gov/history/hps/clg/index.htm	Yes	No	Printable Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	250	0	250
Annual IC Time Burden (Hours)	1,500	1,352	148
Annual IC Cost Burden (Dollars)	313	288	25

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.