Information Collection

Application Form and Recordkeeping

IC 257174 under ICR 202211-1505-003 · OMB 1505-0267.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0267 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Application Form and Recordkeeping	Form and Instruction
Application Form and Recordkeeping	Form and Instruction
Screenshots for ECIP Lending Form.pptx	Other-Screenshots
Screenshots for ECIP Lending Form.pptx	Other-Screenshots
ECIP Application Round Two - ECIP Application - draft version.docx	Form and Instruction
ECIP Application Round Two - ECIP Application - draft version.docx	Form and Instruction

IC Title:

Application Form and Recordkeeping

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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	N/A	ECIP Application	Round Two - ECIP Application - draft version.docx		Yes	Yes	Fillable Fileable
Other-Screenshots			Screenshots for ECIP Lending Form.pptx		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: 25

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	8	8
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.