Information Collection

Remote Video Inspection (RVI)

IC 250797 under ICR 202112-2577-003 · OMB 2577-0298.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2577-0298 can be found here:

Documents and Forms

Document Name Document Type
Form 0000 Remote Video Inspection (RVI) Form and Instruction
Attachment4_Survey of Proxies (002)_PMP.xlsx Other-Excel Spreadsheet
Attachment4_Survey of Proxies (002)_PMP.xlsx Other-Excel Spreadsheet
Attachment5_Survey of Residents_PMP.xlsx Other-Excel Spreadsheet
Attachment5_Survey of Residents_PMP.xlsx Other-Excel Spreadsheet
0000 RVI Checklist Attachment3_RVI Checklist in MS Forms.pdf Form and Instruction
0000 RVI Checklist Attachment3_RVI Checklist in MS Forms.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Remote Video Inspection (RVI)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0000	RVI Checklist	Attachment3_RVI Checklist in MS Forms.pdf	Yes	Yes	Fillable Fileable
Other-Excel Spreadsheet			Attachment4_Survey of Proxies (002)_PMP.xlsx	Yes	Yes	Fillable Fileable
Other-Excel Spreadsheet			Attachment5_Survey of Residents_PMP.xlsx	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 406	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,218	1,218
Annual IC Time Burden (Hours)	300	300
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.