Information Collection

Revitalizing Base Closure Communities, Economic Development Conveyance Annual Financial Statement

IC 5656 under ICR 202101-0790-001 · OMB 0790-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0790-0004 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Exhibt 4_Monmouth_Form_of_Annual_Accounting_of_Revenue_21 Oct 16.docx	Other-Memorandum
Exhibt 4_Monmouth_Form_of_Annual_Accounting_of_Revenue_21 Oct 16.docx	Other-Memorandum
OMB PRA 0790-0004 ADN_2021.docx Agency Disclosure Notice and PRA Information	IC Document
OMB PRA 0790-0004 ADN_2021.docx Agency Disclosure Notice and PRA Information	IC Document

IC Title:

Revitalizing Base Closure Communities, Economic Development Conveyance Annual Financial Statement

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 32 CFR 174.9

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
Other-Memorandum			Exhibt 4_Monmouth_Form_of_Annual_Accounting_of_Revenue_21 Oct 16.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: 24

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	24	-5	29
Annual IC Time Burden (Hours)	960	-200	1,160
Annual IC Cost Burden (Dollars)	33,024	-4,676	37,700

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Agency Disclosure Notice and PRA Information	OMB PRA 0790-0004 ADN_2021.docx	01/11/2021

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