Information Collection

Program Information Sheet Form

IC 221794 under ICR 201806-3137-002 · OMB 3137-0092.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3137-0092 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Program Informatio Program Information Sheet Form	Form and Instruction
Program Informatio Program Information Sheet PIS Final 2018-06-28.pdf www.imls.gov/grants/apply-grant/notices-funding-opportunities/application-forms	Form and Instruction
2017 Program Information Sheet 3137-0092 v2.pdf FY2017 Program Information Sheet	IC Document
Final Justification for Change 3137-0092 GC IMLS Grant Forms - PIS 2017-07-20.docx Justification for Change Request	IC Document
FY18 PIS Final 2017-06-21.docx Program Information Sheet 1	IC Document
FY2018 Program Information Sheet 071917-v2.pdf FY2018 Program Information Sheet	IC Document

IC Title:

Program Information Sheet Form

Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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
Form and Instruction	Program Information Sheet 1	Program Information Sheet	PIS Final 2018-06-28.pdf	https://www.imls.gov/grants/apply-grant/notices-funding-opportunities/application-forms	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,650

Number of Respondents for Small Entity: 300

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,650	273	1,377
Annual IC Time Burden (Hours)	413	69	344
Annual IC Cost Burden (Dollars)	10,403	785	9,618

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
FY2017 Program Information Sheet	2017 Program Information Sheet 3137-0092 v2.pdf	06/21/2017
Justification for Change Request	Final Justification for Change 3137-0092 GC IMLS Grant Forms - PIS 2017-07-20.docx	07/20/2017
Program Information Sheet 1	FY18 PIS Final 2017-06-21.docx	07/20/2017
FY2018 Program Information Sheet	FY2018 Program Information Sheet 071917-v2.pdf	06/28/2018

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