Information Collection

Application

IC 11078 under ICR 201609-1024-004 · OMB 1024-0031.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0031 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-903 Application	Form and Instruction
LWCF Manual.pdf www.nps.gov/ncrc/programs/lwcf/manual/lwcf.pdf	Other-LWCF Manual (Ver. 10/2008)
10-903 LWCF Description and Notification Form 10-903 LWCF Description and Notification Form 09192016.docx www.nps.gov/ncrc/programs/lwcf/pub.htm	Form and Instruction
10-902 LWCF Project Agreement Form 10-902 LWCF Project Agreement Form 09192016.docx www.nps.gov/ncrc/programs/lwcf/pub.htm	Form
10-904 LWCF Proposal Description and Environmental Screening Fo 10-904 LWCF Proposal Description and Environmental Screening Form 09192016.docx www.nps.gov/ncrc/programs/lwcf/pub.htm	Form and Instruction

IC Title:

Application

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 and Instruction	10-903	LWCF Description and Notification Form	10-903 LWCF Description and Notification Form 09192016.docx	http://www.nps.gov/ncrc/programs/lwcf/pub.htm	Yes	No	Fillable Printable
Form	10-902	LWCF Project Agreement Form	10-902 LWCF Project Agreement Form 09192016.docx	http://www.nps.gov/ncrc/programs/lwcf/pub.htm	Yes	No	Fillable Printable
Form and Instruction	10-904	LWCF Proposal Description and Environmental Screening Form	10-904 LWCF Proposal Description and Environmental Screening Form 09192016.docx	http://www.nps.gov/ncrc/programs/lwcf/pub.htm	Yes	No	Fillable Printable
Other-LWCF Manual (Ver. 10/2008)			LWCF Manual.pdf	http://www.nps.gov/ncrc/programs/lwcf/manual/lwcf.pdf	Yes	No	Printable Only

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 60 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	300	0	50	250
Annual IC Time Burden (Hours)	3,600	600	0	3,000
Annual IC Cost Burden (Dollars)	0	0	0	0

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.