Information Collection

Baseline Questionnaire for Certified Local Governments

IC 182868 under ICR 201408-1024-003 · OMB 1024-0038.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.