Information Collection

Nomination Form

IC 235802 under ICR 201904-1250-003 · OMB 1250-0010.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1250-0010 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form EDI Form Nomination Form	Form and Instruction
EDI Form EDI Form OFCCP_EDI Form.pdf	Form and Instruction

IC Title:

Nomination Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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	EDI Form	EDI Form	OFCCP_EDI Form.pdf		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: 67

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	67	67
Annual IC Time Burden (Hours)	1,441	1,441
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.