Information Collection

CDFI Fund Title VI Compliance Worksheet

IC 250850 under ICR 202110-1559-001 · OMB 1559-0053.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CDFI Fund Title VI Compliance Worksheet	Form
CDFI Fund Title VI Compliance Worksheet CDFI Fund Title VI Compliance Worksheet	Form
CDFI Fund Title VI Compliance Worksheet TitleVIComplianceWorksheet_211020.docx	Form
CDFI Fund Title VI Compliance Worksheet CDFI Fund CR Compliance Worksheet 2022-12-22.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 31 CFR 22

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				Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 900

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	900	900
Annual IC Time Burden (Hours)	450	450
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.

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