Information Collection

Hispanic-Serviing Institutions Certification Form

IC 230025 under ICR 202107-3145-003 · OMB 3145-0247.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NSF 1715 Hispanic-Serviing Institutions Certification Form	Form
Certification for PUI Eligibility.docx	Other-Certification of Eligibility
Certification for PUI Eligibility.docx	Other-Certification of Eligibility
NSF 1715 HSI Certification Form HSI Certification Form 1715 07-2018.pdf	Form
NSF 1715 HSI Certification Form HSI Certification Form 1715 07-2018.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	NSF 1715	HSI Certification Form	HSI Certification Form 1715 07-2018.pdf		No		Fillable Printable
Other-Certification of Eligibility			Certification for PUI Eligibility.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 175

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	175	0	175
Annual IC Time Burden (Hours)	6	0	6
Annual IC Cost Burden (Dollars)	1,750	1,750	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.