Local Government

Diesel Emissions Reduction Act (DERA) Rebate Program (Renewal)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2060-0686 can be found here:

Documents and Forms

Document Name Document Type
Form 5600-260 Local Government Form and Instruction
5600-260 Rebate Application fy18-clean-diesel-rebate-application.pdf www.epa.gov/sites/production/files/2018-10/... Form and Instruction
5600-261 Rebate Payment Request Attachment B- Payment Request Form.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Local Government	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	5600-260	Rebate Application	fy18-clean-diesel-rebate-application.pdf	https://www.epa.gov/sites/production/files/2018-10/...	Yes	Yes	Fillable Printable
Form and Instruction	5600-261	Rebate Payment Request	Attachment B- Payment Request Form.pdf		Yes	Yes	Fillable Printable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 519	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	583	493	90
Annual IC Time Burden (Hours)	2,527	2,212	315
Annual IC Cost Burden (Dollars)	0	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.