Information Collection

CDFI Fund Title VI Compliance Worksheet

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

Documents and Forms

Document Name Document Type
CDFI Fund Title VI Compliance Worksheet Form
CDFI Fund Title VI Compliance Worksheet TitleVIComplianceWorksheet_211020.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CDFI Fund Title VI Compliance Worksheet	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	n/a	CDFI Fund Title VI Compliance Worksheet	TitleVIComplianceWorksheet_211020.docx		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 %

	Requested	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

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.