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

Historic Preservation Certifications, 36 CFR Part 67

⚠️ Notice: This information collection may be referencing outdated material.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 10-168c HPCA Part 3 - Request for Certification of Completed Work (Private Sector) 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

Information Collection (IC) Details

IC Title:	HPCA Part 3 - Request for Certification of Completed Work (Private Sector)	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	10-168c	HPCA Part 3 - Request for Certification of Completed Work	NPS Form 10-168c Part 3 Request for Certification of Completed Work 2019.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: 1,000	Number of Respondents for Small Entity: 228

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,000	159	841
Annual IC Time Burden (Hours)	12,000	-2,297	14,297
Annual IC Cost Burden (Dollars)	1,500,000	135,898	1,364,102

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.