Information Collection

Letter of Intent (LOI) Form - State, Local & Tribal Gov't

IC 217597 under ICR 202201-0524-004 · OMB 0524-0039.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0524-0039 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Letter of Intent (LOI) Form - State, Local & Tribal Gov't	Form
Letter of Intent (LOI) Form 0524-0039 Letter of Intent Form (002).pdf	Form
Letter of Intent (LOI) Form 0524-0039 Letter of Intent Form (002).pdf	Form

IC Title:

Letter of Intent (LOI) Form - State, Local & Tribal Gov't

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 3019.53 p(b)(1-4)

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
Form	N/A	Letter of Intent (LOI) Form	0524-0039 Letter of Intent Form (002).pdf		Yes	Yes	Fillable Printable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,739

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,739	2,739
Annual IC Time Burden (Hours)	1,497	1,497
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.