Information Collection

Uniform Certification Application Form

IC 213904 under ICR 201808-2105-001 · OMB 2105-0510.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2105-0510 can be found here:

Documents and Forms

Document Name Document Type
Form Appendix F Uniform Certification Application Form Form and Instruction
Appendix F Certification Application For Internal Coordination Certification Application Tech Corrections Final 7-27-18.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Uniform Certification Application Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 49 CFR Part 26 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Appendix F	Certification Application For Internal Coordination	Certification Application Tech Corrections Final 7-27-18.doc		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: 9,500	Number of Respondents for Small Entity: 9,500

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	9,500	9,500
Annual IC Time Burden (Hours)	76,000	76,000
Annual IC Cost Burden (Dollars)	0	0

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.