Information Collection

Input Form

IC 214351 under ICR 202101-1084-001 · OMB 1084-0034.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1084-0034 can be found here:

Documents and Forms

Document Name Document Type
Input Form Form and Instruction
Inputon Collections from Lands Administered by the Department of the Interior that are located at non-Federal Facilities Input Form Form and Instruction
INPUT ON COLLECTIONS FROM LANDS ADMINISTERED BY THE DEPA Input Form - REVISED 5-18-15 Final.pdf www.surveygizmo.com/s3/1934156/DOI-Input-on-Collections-Form Form and Instruction
Inputon Collections from Lands Administered by the Depar Input Form - 11-3-21 Final.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Input Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

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	None	Inputon Collections from Lands Administered by the Department of the Interior that are located at non-Federal Facilities	Input Form - 11-3-21 Final.pdf		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	100	0	100
Annual IC Time Burden (Hours)	3,250	2,050	1,200
Annual IC Cost Burden (Dollars)	0	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.

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