Information Collection

Claim for loss

IC 178452 under ICR 202202-1076-009 · OMB 1076-0020.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0020 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CFL10 Claim for loss	Form and Instruction
CFL10 Claim for Loss CFL10 - Claim for Loss 2022 Fillable.doc.pdf www.bia.gov/policy-forms/online-forms	Form and Instruction
CFL10 Claim for Loss CFL10 - Claim for Loss 2022 Fillable.doc.pdf www.bia.gov/policy-forms/online-forms	Form and Instruction

IC Title:

Claim for loss

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 103.37

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 and Instruction	CFL10	Claim for Loss	CFL10 - Claim for Loss 2022 Fillable.doc.pdf	https://www.bia.gov/policy-forms/online-forms	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title: BIA-13, Loan Management and Accounting System

FR Citation: 73 FR 40595

Number of Respondents: 10

Number of Respondents for Small Entity: 6

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	20	20
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.