Information Collection

Application for an Incentive Plan Agreement (IPA) and List of IPA Participants

IC 196985 under ICR 201604-0648-003 · OMB 0648-0401.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0648-0401 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Application for an Incentive Plan Agreement (IPA) and List of IPA Participants	Form and Instruction
IPA Application 0401 requestforapproval IPA 122415.docx	Form and Instruction

IC Title:

Application for an Incentive Plan Agreement (IPA) and List of IPA Participants

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	NA	IPA Application	0401 requestforapproval IPA 122415.docx		Yes	Yes	Fillable Fileable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1

Number of Respondents for Small Entity: 1

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1	0	1
Annual IC Time Burden (Hours)	50	10	40
Annual IC Cost Burden (Dollars)	1	0	1

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.