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Federal forms, ICRs, and supporting documents

Information Collection

Personal Net Worth Form

IC 213920 under ICR 202112-2105-001 · OMB 2105-0510.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Personal Net Worth Form
 
No Modified
 
Required to Obtain or Retain Benefits
 
49 CFR Part 26  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Appendix G Personal Net Worth Statement PNW Statement Tech Corrections Final.docx Yes Yes Fillable Fileable

Economic Development Business and Industry Development

 

9,500 9,500
   
Private Sector Businesses or other for-profits
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 9,500 0 0 0 9,500 0
Annual IC Time Burden (Hours) 95,000 0 0 76,000 19,000 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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