Local Government Certifications

CARES Act Coronavirus Relief Fund for State, Local and Tribal Governments

Documents and Forms

Document Name Document Type
Local Government Certifications Form and Instruction
Government Certifications 1505-0264 - Certification for CARES Act-Title V Coronavirus Relief Funds 4-11-20.docx Form and Instruction
Government Certifications 1505-0264 - Certification for CARES Act-Title V Coronavirus Relief Funds 4-11-20.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Local Government Certifications	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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
Form and Instruction	n/a	Government Certifications	1505-0264 - Certification for CARES Act-Title V Coronavirus Relief Funds 4-11-20.docx		Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	0	0	0	0	0	0
Annual IC Time Burden (Hours)	0	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	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.