Information Collection

Nomination as National Historical Landmark - indiv

IC 217982 under ICR 201812-1024-004 · OMB 1024-0276.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0276 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-934 Nomination as National Historical Landmark - indiv	Form
1024-0276 form instructions.pdf www.nps.gov/nhl/apply/write.htm	Instruction
10-934 National Historical Landmark Nomination 1024-0276 Form10-934.(ver12.18).doc	Form

IC Title:

Nomination as National Historical Landmark - indiv

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 36 CFR 65

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	10-934	National Historical Landmark Nomination	1024-0276 Form10-934.(ver12.18).doc		No		Fillable Printable
Instruction			1024-0276 form instructions.pdf	http://www.nps.gov/nhl/apply/write.htm	Yes	No	Printable Only

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	1,720	1,720
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.