Information Collection

Qualifying Activity Confirmation Request Form

IC 248709 under ICR 202108-1557-001 · OMB 1557-0356.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1557-0356 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Qualifying Activity Confirmation Request Form	Form
Qualifying Activity Confirmation Request Form Qualifying Activity Confirmation Request Form_Revised_03092022.docx	Form

IC Title:

Qualifying Activity Confirmation Request 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	Qualifying Activity Confirmation Request Form	Qualifying Activity Confirmation Request Form_Revised_03092022.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 120

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	2,280	2,280
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.