Information Collection

HPCA Part 3 - Request for Certification of Completed Work (Individuals)

IC 190587 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form 10-168c HPCA Part 3 - Request for Certification of Completed Work HPCA Part 3 - Request for Certification of Completed Work (Individuals)	Form and Instruction
10-168c HPCA Part 3 - Request for Certification of Completed Wor NPS Form 10-168c Part 3 Request for Certification of Completed Work 2019.docx	Form and Instruction

IC Title:

HPCA Part 3 - Request for Certification of Completed Work (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:

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	10-168c				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: 53

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	53	9	44
Annual IC Time Burden (Hours)	636	-112	748
Annual IC Cost Burden (Dollars)	6,466	-64,902	71,368

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.

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