CAP Assessor Feedback Form

IMLS Collections Assessment for Preservation Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3137-0126 can be found here:

Documents and Forms

Document Name Document Type
Form CAP Assessor Feedb CAP Assessor Feedback Form Form and Instruction
CAP Assessor Feedb CAP Assessor Feedback Form CAP Assessor Feedback Form-20210308.docx Form and Instruction
CAP Assessor Feedb CAP Assessor Feedback Form CAP Assessor Feedback Form-20210308.docx Form and Instruction

Information Collection (IC) Details

IC Title:	CAP Assessor Feedback Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	CAP Assessor Feedback Form 1	CAP Assessor Feedback Form	CAP Assessor Feedback Form-20210308.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 160

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	66	66
Annual IC Cost Burden (Dollars)	1,876	1,876

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.