Information Collection

Application for Domestic Indemnification

IC 246725 under ICR 202003-3135-010 · OMB 3135-0123.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3135-0123 can be found here:

Documents and Forms

Document Name Document Type
Domestic Indemnity Application Instructions 2020.pdf Domestic Indemnity Application Instructions IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Domestic Indemnification	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 201

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 18	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	18	18
Annual IC Time Burden (Hours)	720	720
Annual IC Cost Burden (Dollars)	37,746	37,746

Documents for IC

Title	Document	Date Uploaded
Domestic Indemnity Application Instructions	Domestic Indemnity Application Instructions 2020.pdf	04/07/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.