Information Collection

Signed Agreement Listing All Known Repairs

IC 233328 under ICR 201806-0575-002 · OMB 0575-0189.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0575-0189 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Signed Agreement Listing All Known Repairs	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 3560

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 95	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	95	95
Annual IC Time Burden (Hours)	95	95
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.