Information Collection

Measures that Matter Needs Assessment

IC 250306 under ICR 202111-3137-004 · OMB 3137-0131.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Case Study Interview Protocols_Appendix I_ 20211106.docx	Instruction
IMLS MtM Appendix I_Case Study Interview Protocols_Version2_20220208.docx	Instruction
MtM Burden Estimate 20211106.xlsx IMLS MtM Burden Estimate	IC Document
MtM Burden Estimate 20211106.xlsx IMLS MtM Burden Estimate	IC Document
Case Study Interview Protocols_Appendix I_ Version 1_20211106.docx Supplementary Documents: Appendices	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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
Instruction			IMLS MtM Appendix I_Case Study Interview Protocols_Version2_20220208.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 130

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	130	130
Annual IC Time Burden (Hours)	98	98
Annual IC Cost Burden (Dollars)	2,664	2,664

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
IMLS MtM Burden Estimate	MtM Burden Estimate 20211106.xlsx	11/10/2021
Supplementary Documents: Appendices	Case Study Interview Protocols_Appendix I_ Version 1_20211106.docx	02/11/2022

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