Information Collection

Application for Indemnification

IC 32834 under ICR 201705-3135-002 · OMB 3135-0094.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3135-0094 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3135-0094 Application for Indemnification	Form and Instruction
3135-0094 Arts and Artifacts Indemnity Program International Indem International Indemnity Application Instructions.pdf www.arts.gov/grants/apply/indemnity/indemnityinternational.html	Form and Instruction

IC Title:

Application for Indemnification

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 201

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	3135-0094	Arts and Artifacts Indemnity Program International Indemnity	International Indemnity Application Instructions.pdf	http://www.arts.gov/grants/apply/indemnity/indemnityinternational.html	Yes	Yes	Fillable Fileable Signable

Line of Business: Education

Subfunction: Cultural and Historic Exhibition

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	40	-10	50
Annual IC Time Burden (Hours)	1,786	-447	2,233
Annual IC Cost Burden (Dollars)	72,000	-18,000	90,000

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.