Information Collection

1000.382 - Annual self-governance report

IC 190042 under ICR 201903-1076-007 · OMB 1076-0143.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0143 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
1000.382 - Annual self-governance report	Form
Self-Governance Minimum Data Collection 1076-0143 Form.doc 64.58.34.34/osg/default.aspx	Form

IC Title:

1000.382 - Annual self-governance report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 1000.382

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	N/A	Self-Governance Minimum Data Collection	1076-0143 Form.doc	http://64.58.34.34/osg/default.aspx	Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 33

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 30 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	33	33
Annual IC Time Burden (Hours)	2,112	2,112
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.