National Medal for Museum and Library Service Nomination Form

National Medal for Museum and Library Service form and cover sheet

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3137-0097 can be found here:

Documents and Forms

Document Name Document Type
Form National Medal Nom National Medal for Museum and Library Service Nomination Form Form and Instruction
National Medal Nom National Medal Nomination Form 2023 National Medals Nomination Form 20220425.docx www.imls.gov/our-work/national-medal-museum-and-library-service Form and Instruction
National Medal Nom National Medal Nomination Form 2023 National Medals Nomination Form 20220425.docx www.imls.gov/our-work/national-medal-museum-and-library-service Form and Instruction
2022 National Medals Nomination Form 210415.docx 2022 National Medal Nomination Form IC Document
2022 National Medals Nomination Form 210415.docx 2022 National Medal Nomination Form IC Document

Information Collection (IC) Details

IC Title:	National Medal for Museum and Library Service Nomination Form	Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	National Medal Nomination Form 1	National Medal Nomination Form	2023 National Medals Nomination Form 20220425.docx	https://www.imls.gov/our-work/national-medal-museum-and-library-service	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 175	Number of Respondents for Small Entity: 44

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	175	175
Annual IC Time Burden (Hours)	1,575	1,575
Annual IC Cost Burden (Dollars)	47,407	47,407

Documents for IC

Title	Document	Date Uploaded
2022 National Medal Nomination Form	2022 National Medals Nomination Form 210415.docx	04/25/2022

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