Information Collection

Loan and Payroll Support Applications and Agreements

IC 241028 under ICR 202110-1505-001 · OMB 1505-0263.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0263 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Loan and Payroll Support Applications and Agreements	Form and Instruction
APRIL 5 2020 special rule reporting email_clean.docx	Other-email template
APRIL 5 2020 special rule reporting email_clean.docx	Other-email template
Withdrawal Agreement 1505-0263 4003, 4112 & 4113_PSP withdrawal agreement.docx	Form and Instruction
Withdrawal Agreement 1505-0263 4003, 4112 & 4113_PSP withdrawal agreement.docx	Form and Instruction
Payroll Support Program Extension (PSP2) Application For 1505-0263 DRAFT PSP2 Application for PSP1 Participants with Taxpyer Protection.docx home.treasury.gov/policy-issues/cares/preserving-jobs-for-american-industry	Form
Payroll Support Program Extension (PSP2) Application For 1505-0263 DRAFT PSP2 Application for PSP1 Participants with Taxpyer Protection.docx home.treasury.gov/policy-issues/cares/preserving-jobs-for-american-industry	Form
Payroll Support Program Extension Agreement 1505-0263 - PSP2 Agreement.docx home.treasury.gov/policy-issues/cares/preserving-jobs-for-american-industry	Form and Instruction
Payroll Support Program Extension Agreement 1505-0263 - PSP2 Agreement.docx home.treasury.gov/policy-issues/cares/preserving-jobs-for-american-industry	Form and Instruction
Payroll Support Program Extension (PSP2) Application (On 1505-0263 PSP2 Application Portal Screenshots 2021-01-08v2.pptx home.treasury.gov/policy-issues/cares/preserving-jobs-for-american-industry	Form and Instruction
Payroll Support Program Extension (PSP2) Application (On 1505-0263 PSP2 Application Portal Screenshots 2021-01-08v2.pptx home.treasury.gov/policy-issues/cares/preserving-jobs-for-american-industry	Form and Instruction
Payroll Support Program Extension Agreement - Contractor FormofPayrollSupportAgreementContractors.pdf	Form and Instruction
Payroll Support Program Extension Agreement - Contractor FormofPayrollSupportAgreementContractors.pdf	Form and Instruction
Payroll Support Program Extension Agreement - Air Carrie FormofPayrollSupportAgreementPassengerAirCarriers.pdf	Form and Instruction
Payroll Support Program Extension Agreement - Air Carrie FormofPayrollSupportAgreementPassengerAirCarriers.pdf	Form and Instruction
Payroll Support Program (PSP1) Recall Waiver Form PSP1 Recall Waiver Form v3.pdf	Form and Instruction
Payroll Support Program (PSP1) Recall Waiver Form PSP1 Recall Waiver Form v3.pdf	Form and Instruction
Recertification of PSP1 Sworn Financial Statements PSP1 Re-certification Form v2.pptx	Form and Instruction
Recertification of PSP1 Sworn Financial Statements PSP1 Re-certification Form v2.pptx	Form and Instruction
Certification of Recall Notice Requirements - Involuntar 1505-0263 CERTIFICATION OF RECALL NOTICE REQUIREMENT - INVOLUNTARY FURLOUGHS 2021-03-02.docx	Form and Instruction
Certification of Recall Notice Requirements - Involuntar 1505-0263 CERTIFICATION OF RECALL NOTICE REQUIREMENT - INVOLUNTARY FURLOUGHS 2021-03-02.docx	Form and Instruction
Certification of Recall Notice Requirement - No Involunt 1505-0263 CERTIFICATION OF RECALL NOTICE REQUIREMENT - NO INVOLUNTARY FURLOUGHS 2021-03-02.docx	Form and Instruction
Certification of Recall Notice Requirement - No Involunt 1505-0263 CERTIFICATION OF RECALL NOTICE REQUIREMENT - NO INVOLUNTARY FURLOUGHS 2021-03-02.docx	Form and Instruction
Recall Screenshots PSP2 Recall Certification Form v3.pdf	Form and Instruction
Recall Screenshots PSP2 Recall Certification Form v3.pdf	Form and Instruction
PSP1 Special Rule PSP 1 Special Rule Portal with confirmation emails (May)_clean.docx	Form and Instruction
PSP1 Special Rule PSP 1 Special Rule Portal with confirmation emails (May)_clean.docx	Form and Instruction
Payroll Support Program 3 Agreements PSP3 agreement - FINAL.docx	Form and Instruction
Payroll Support Program 3 Agreements PSP3 agreement - FINAL.docx	Form and Instruction
PSP1 Award Recertification PSP1 Carrier Award Certification Portal_Final - 4-28-21.docx	Form and Instruction
PSP1 Award Recertification PSP1 Carrier Award Certification Portal_Final - 4-28-21.docx	Form and Instruction
PSP3 Withdrawal Agreement Template for CARES PSP 3 withdrawal agreement (clean).docx	Form and Instruction
PSP3 Withdrawal Agreement Template for CARES PSP 3 withdrawal agreement (clean).docx	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Loan and Payroll Support Applications and Agreements

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 and Instruction	n/a	Withdrawal Agreement	1505-0263 4003, 4112 & 4113_PSP withdrawal agreement.docx		Yes	Yes	Fillable Fileable
Form	N/A	Payroll Support Program Extension (PSP2) Application Form	1505-0263 DRAFT PSP2 Application for PSP1 Participants with Taxpyer Protection.docx	https://home.treasury.gov/policy-issues/cares/preserving-jobs-for-american-industry	Yes	Yes	Fillable Fileable Signable
Form and Instruction	N/A	Payroll Support Program Extension Agreement	1505-0263 - PSP2 Agreement.docx	https://home.treasury.gov/policy-issues/cares/preserving-jobs-for-american-industry	Yes	Yes	Fillable Fileable Signable
Form and Instruction	N/A	Payroll Support Program Extension (PSP2) Application (Online Portal)	1505-0263 PSP2 Application Portal Screenshots 2021-01-08v2.pptx	https://home.treasury.gov/policy-issues/cares/preserving-jobs-for-american-industry	Yes	Yes	Fillable Fileable Signable
Form and Instruction	N/A	Payroll Support Program Extension Agreement - Contractors	FormofPayrollSupportAgreementContractors.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Payroll Support Program Extension Agreement - Air Carriers	FormofPayrollSupportAgreementPassengerAirCarriers.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Payroll Support Program (PSP1) Recall Waiver Form	PSP1 Recall Waiver Form v3.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Recertification of PSP1 Sworn Financial Statements	PSP1 Re-certification Form v2.pptx		Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Certification of Recall Notice Requirements - Involuntary Furloughs	1505-0263 CERTIFICATION OF RECALL NOTICE REQUIREMENT - INVOLUNTARY FURLOUGHS 2021-03-02.docx		Yes	Yes	Fillable Fileable Signable
Form and Instruction	N/A	Certification of Recall Notice Requirement - No Involuntary Furloughs	1505-0263 CERTIFICATION OF RECALL NOTICE REQUIREMENT - NO INVOLUNTARY FURLOUGHS 2021-03-02.docx		Yes	Yes	Fillable Fileable Signable
Form and Instruction	n/a	Recall Screenshots	PSP2 Recall Certification Form v3.pdf		Yes	Yes	Fillable Fileable
Other-email template			APRIL 5 2020 special rule reporting email_clean.docx		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	PSP1 Special Rule	PSP 1 Special Rule Portal with confirmation emails (May)_clean.docx		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Payroll Support Program 3 Agreements	PSP3 agreement - FINAL.docx		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	PSP1 Award Recertification	PSP1 Carrier Award Certification Portal_Final - 4-28-21.docx		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	PSP3 Withdrawal Agreement	Template for CARES PSP 3 withdrawal agreement (clean).docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Economic Development

Subfunction: Industry Sector Income Stabilization

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 600

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	1,170	1,170
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.