Information Collection

Local Government Certification Application/Agreement (CLG)

IC 228628 under ICR 201710-1024-001 · OMB 1024-0038.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0038 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2017 Local Government Certification Application - Agreement.pdf	Instruction

IC Title:

Local Government Certification Application/Agreement (CLG)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 36 CFR 61

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
Instruction			2017 Local Government Certification Application - Agreement.pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	450	450
Annual IC Cost Burden (Dollars)	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.