Information Collection

HPCA Part 2 - Description of Rehabilitation (Individuals)

IC 190584 under ICR 201911-1024-002 · OMB 1024-0009.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0009 can be found here:

Documents and Forms

Document Name Document Type
Form 10-168a HPCA Part 2 - Description of Rehabilitation HPCA Part 2 - Description of Rehabilitation (Individuals) Form and Instruction
10-168a HPCA Part 2 - Description of Rehabilitation 10-168a HPCA Part 2 07242019.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	HPCA Part 2 - Description of Rehabilitation (Individuals)	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 67

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	10-168a	HPCA Part 2 - Description of Rehabilitation	10-168a HPCA Part 2 07242019.docx		Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 77	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	77	12	65
Annual IC Time Burden (Hours)	3,927	612	3,315
Annual IC Cost Burden (Dollars)	133,518	20,808	112,710

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.

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