Information Collection

HPCA Part 1 - Evaluation of Significance (Individuals)

IC 43757 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⚠️ Notice: This information collection may be referencing outdated material.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 10-168 HPCA Part 1 HPCA Part 1 - Evaluation of Significance (Individuals)	Form and Instruction
10-168 HPCA Part 1 NPS Form 10-168 Part 1 Evaluation of Significance 2019 (1).docx	Form and Instruction

IC Title:

HPCA Part 1 - Evaluation of Significance (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	10-168				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: 88

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	88	14	74
Annual IC Time Burden (Hours)	1,320	-678	1,998
Annual IC Cost Burden (Dollars)	6,688	1,064	5,624

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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