Application for Admission to Haskell Indian Nations University

Application for Admission to Haskell Indian Nations University and to Southwestern Indian Polytechnic Institute

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0114 can be found here:

Documents and Forms

Document Name Document Type
Application for Admission to Haskell Indian Nations University Form and Instruction
Haskell Application for Admission FillableApplication_2017 UPDATE.pdf www.haskell.edu Form and Instruction

Information Collection (IC) Details

IC Title:	Application for Admission to Haskell Indian Nations University	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 25 CFR 32

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Haskell Application for Admission	FillableApplication_2017 UPDATE.pdf	www.haskell.edu	No		Paper Only

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title: BIA-22 "Indian Student Records"	FR Citation: 73 FR 40605

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,000	0	0	1,000
Annual IC Time Burden (Hours)	250	0	-250	500
Annual IC Cost Burden (Dollars)	10,000	1,275	-1,865	10,590

Documents for IC

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.