Information Collection

Communities for Immunity Evaluation (Round 1)

IC 249891 under ICR 202110-3137-001 · OMB 3137-0129.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3137-0129 can be found here:

Documents and Forms

Document Name Document Type
IMLS OMB C4I Round 1_Data Instruments_20211021.pdf Instruction
IMLS OMB C4I Round 1_Data Instruments_20211115.pdf Instruction
IMLS OMB C4I Round 1 Burden Estimate 20211021.xlsx Burden Estimate FY22 IC Document
IMLS OMB C4I Round 1 Burden Estimate 20211021.xlsx Burden Estimate FY22 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Communities for Immunity Evaluation (Round 1)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			IMLS OMB C4I Round 1_Data Instruments_20211115.pdf		Yes	Yes	Paper Only

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,188	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,188	1,188
Annual IC Time Burden (Hours)	120	120
Annual IC Cost Burden (Dollars)	4,688	4,688

Documents for IC

Title	Document	Date Uploaded
Burden Estimate FY22	IMLS OMB C4I Round 1 Burden Estimate 20211021.xlsx	10/22/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.