Multipurpose Reimbursement Checklist -- Certified Cost or Pricing Data Required

Requests for Reimbursement under Section 3610 of the CARES Act

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0750-0003 can be found here:

Documents and Forms

Document Name Document Type
TAB A2 - Multipurpose Reimb Checklist - 2020-OZZZZ 08.11.20 Final.docx Instruction

Information Collection (IC) Details

IC Title:	Multipurpose Reimbursement Checklist -- Certified Cost or Pricing Data Required	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Instruction			TAB A2 - Multipurpose Reimb Checklist - 2020-OZZZZ 08.11.20 Final.docx		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 404	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	404	404
Annual IC Time Burden (Hours)	64,640	64,640
Annual IC Cost Burden (Dollars)	3,668,966	3,668,966

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.