Tribal Affidavit

CARES Act Coronavirus Relief Fund for SLT

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0264 can be found here:

Documents and Forms

Document Name Document Type
Tribal Affidavit Form and Instruction
Instructions for Request for Information_Final.docx Instruction
Certification for Requested Tribal Data 1505-0264 - Certification for CARES Act - Tribal Data 4-11-20.docx Form and Instruction
Tribal RFI Worksheet TRIBAL RFI WORKSHEET Final.xlsx Form

Information Collection (IC) Details

IC Title:	Tribal Affidavit	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Certification for Requested Tribal Data	1505-0264 - Certification for CARES Act - Tribal Data 4-11-20.docx	Yes	Yes	Fillable Fileable
Form	n/a	Tribal RFI Worksheet	TRIBAL RFI WORKSHEET Final.xlsx	Yes	Yes	Fillable Fileable
Instruction			Instructions for Request for Information_Final.docx	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 750	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	750	750
Annual IC Time Burden (Hours)	1,500	1,500
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.