Information Collection

Revitalizing Base Closure Communities, Economic Development Conveyance Annual Financial Statement

IC 5656 under ICR 201712-0790-001 · OMB 0790-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0790-0004 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Exhibt 4_Monmouth_Form_of_Annual_Accounting_of_Revenue_21 Oct 16.docx	Other-Memorandum
OMB PRA 0790-0004 ADN.doc	Other-Agency Disclosure Notice

IC Title:

Revitalizing Base Closure Communities, Economic Development Conveyance Annual Financial Statement

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 32 CFR 174.9

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
Other-Memorandum			Exhibt 4_Monmouth_Form_of_Annual_Accounting_of_Revenue_21 Oct 16.docx		Yes	Yes	Fillable Fileable
Other-Agency Disclosure Notice			OMB PRA 0790-0004 ADN.doc		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 29

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

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	29	-11	40
Annual IC Time Burden (Hours)	1,160	-440	1,600
Annual IC Cost Burden (Dollars)	37,700	22,620	15,080

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.