10-900-a National Register of Historic Places Continuation Sheet

NPS Form 10-900-a (Rev. 03/2021)
National Park Service

0MB Control No. 1024-0018

NATIONAL REGISTER OF HISTORIC PLACES REGISTRATION
FORM
CONTINUATION SHEET

Section Number

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Page

Name of multiple listings (if applicable):

Name of Property:
County and State:

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NPS Fo rm 10-900-a (Rev. 03/2021)
Natio n al Park Service

Section Number

0MB Co n tro l No . 1024-0018
Exp iratio n Date 03/31/2022

Page

Name of multiple listings (if applicable):

Name of Property:
County and State:

NPS Fo rm 10-900-a (Rev. 03/2021)
Natio n al Park Service

0MB Co n tro l No . 1024-0018
Exp iratio n Date 03/31/2022

NOTICES
Privacy Act Statement
Authority: This inf ormation collection is authorized by the National Historic Preservation Act, as amended (16 U.S.C.460
et seq.), and 36 CFR 60 and 63.
Purposes and Uses: This inf ormation is being collected f or nominations to the National Register of Historic Places to
nominate properties f or listing or determine eligibility f or listing, to list properties, and to amend existing listings.
Ef f ects of Nondisclosure: Voluntary, however, response to this request is required to obtain a benef it in accordance with
the National Historic Preservation Act, as amended (16 U.S.C.460 et seq.).
Paperwork Reduction Act Statement
The Paperwork Reduction Act requires us to tell you why we are collecting this inf ormation, how we will use it,
and whether or not you have to respond. Pursuant to National Historic Preservation Act, as amended (16
U.S.C.460 et seq.), and 36 CFR 60 and 63, this inf ormation is collected f rom applicants nominating properties to the
National Register of Historic Places f or listing or determine eligibility f or listing, to list properties, and to amend existing
listings. to provide the necessary f acts to enable the Secretary of the Interior to evaluate the applicant's eligibility f or
inclusion in the National Register of Historic Places. A f ederal agency may not conduct or sponsor, and a person
is not required to respond to, a collection of inf ormation unless it displays a valid OMB control number. OMB has
approved this collection of inf ormation and assigned Control No. 1024-0018.
Estimated Burden Statement
Public reporting burden f or this f orm is estimated to average 250 hours per response including time f or reviewing
instructions, gathering and maintaining data, and completing and reviewing the f orm. Send comments regarding this burden
estimate or any other aspect of this collection of inf ormation, including suggestions f or reducing this burden, to the
Inf ormation Collection Clearance Of f icer, National Park Service, 12201 Sunrise Valley Drive Reston, Virginia 20192. Do not
send your completed f orm to this address.

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