Information Collection

Version 2 - Statistical Report and Instructions

IC 213828 under ICR 201411-1076-001 · OMB 1076-0135.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0135 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form None. Version 2 - Statistical Report and Instructions	Form and Instruction
None. Version 2 - Statistical Report and Instructions FINAL 477 Statistical Report and Instructions.docx	Form and Instruction
477 Cost Categories FINAL.pdf Functional Cost Categories	IC Document

IC Title:

Version 2 - Statistical Report and Instructions

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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 and Instruction	None.	Version 2 - Statistical Report and Instructions	FINAL 477 Statistical Report and Instructions.docx		Yes	Yes	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title: BIA-8, Indian Social Services Case

FR Citation: 55 FR 34085

Number of Respondents: 42

Number of Respondents for Small Entity: 42

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 1 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	42	42
Annual IC Time Burden (Hours)	840	840
Annual IC Cost Burden (Dollars)	210	210

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Functional Cost Categories	477 Cost Categories FINAL.pdf	11/12/2014

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