Certification Regarding Economic Conditions (for Eligible Tribal Governments)

Local Assistance and Tribal Consistency Fund

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0276 can be found here:

Documents and Forms

Document Name Document Type
Certification Regarding Economic Conditions (for Eligible Tribal Governments) Form and Instruction
Tribal Certification Regarding Economic Conditions Tribal Certification Regarding Economic Conditions_Emergency.docx Form and Instruction
Tribal Certification Regarding Economic Conditions Tribal Certification Regarding Economic Conditions_Emergency.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Certification Regarding Economic Conditions (for Eligible Tribal Governments)	Agency IC Tracking Number:	N/A

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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	N/A	Tribal Certification Regarding Economic Conditions	Tribal Certification Regarding Economic Conditions_Emergency.docx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 581	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	581	581
Annual IC Time Burden (Hours)	581	581
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.