Information Collection

Request for Extension Form

IC 247871 under ICR 202106-1505-002 · OMB 1505-0271.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0271 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Request for Extension Form	Form
Request for Extension 1505-0271 NEU Extensions Form.docx	Form
Request for Extension 1505-0271 NEU Extensions Form.docx	Form

IC Title:

Request for Extension Form

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	Request for Extension	1505-0271 NEU Extensions Form.docx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 55

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	55	55
Annual IC Time Burden (Hours)	55	55
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.