Information Collection

Reimbursement Request

IC 212951 under ICR 201711-3133-003 · OMB 3133-0138.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3133-0138 can be found here:

Documents and Forms

Document Name Document Type
Reimbursement Request Form
Reimbursement Upload Screenshot.png www.cybergrants.com Other-Reimbursement Screenshot
Student Certification of Business Hours Certification of Business Hours Form_2014 v2.pdf www.cybergrants.com Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Reimbursement Request	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 12 CFR 705.10

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	None	Student Certification of Business Hours	Certification of Business Hours Form_2014 v2.pdf	www.cybergrants.com	Yes	Yes	Fillable Printable
Other-Reimbursement Screenshot			Reimbursement Upload Screenshot.png	www.cybergrants.com	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 144	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 99 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-144	144
Annual IC Time Burden (Hours)	-864	864
Annual IC Cost Burden (Dollars)	-25,920	25,920

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.