Information Collection

Gravesite Reservation Questionnaire (2 Year)

IC 28725 under ICR 201704-2900-007 · OMB 2900-0546.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0546 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FL 40-40 Gravesite Reservation Questionnaire (2 Year)	Form and Instruction
FL 40-40 Gravesite Reservation Questionnaire (2 Year) FL40-40 (3).pdf	Form and Instruction

IC Title:

Gravesite Reservation Questionnaire (2 Year)

Agency IC Tracking Number:

2900-0546

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	FL 40-40	Gravesite Reservation Questionnaire (2 Year)	FL40-40 (3).pdf		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	25,000	8,500	16,500
Annual IC Time Burden (Hours)	4,167	1,417	2,750
Annual IC Cost Burden (Dollars)	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.