Information Collection

Request for Significant Change of Use

IC 208700 under ICR 201912-1024-007 · OMB 1024-0031.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0031 can be found here:

Documents and Forms

Document Name Document Type
Form 10-904 Request for Significant Change of Use Form and Instruction
LWCF Manual 2019.pdf www.nps.gov/ncrc/programs/lwcf/manual/lwcf.pdf Other-LWCF Manual 2019
10-904 LWCF Proposal Description and Environmental Screening Fo 10-904 A&R Form (vice PD-ESF).pdf www.nps.gov/ncrc/programs/lwcf/pub.htm Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Significant Change of Use	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	10-904	LWCF Proposal Description and Environmental Screening Form	10-904 A&R Form (vice PD-ESF).pdf	http://www.nps.gov/ncrc/programs/lwcf/pub.htm	Yes	No	Fillable Printable
Other-LWCF Manual 2019			LWCF Manual 2019.pdf	http://www.nps.gov/ncrc/programs/lwcf/manual/lwcf.pdf	Yes	No	Printable Only

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2	2
Annual IC Time Burden (Hours)	32	32
Annual IC Cost Burden (Dollars)	0	0

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.