Information Collection

Impact Assessment Questionnaire: COVID-19 Response Version

IC 241586 under ICR 202211-3015-001 · OMB 3015-0009.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DFC-007a Impact Assessment Questionnaire: COVID-19 Response Version	Form and Instruction
DFC-007a Impact Assessment Questionnaire: COVID-19 Response Versi DFC-007a COVID-19 Response Version.xlsm	Form and Instruction
DFC-007a Impact Assessment Questionnaire: COVID-19 Response Versi DFC-007a COVID-19 Response Version.xlsm	Form and Instruction

IC Title:

Agency IC Tracking Number:

DFC-007a

Is this a Common Form? No

IC Status: Removed

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	DFC-007a	Impact Assessment Questionnaire: COVID-19 Response Version	DFC-007a COVID-19 Response Version.xlsm		Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

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: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-25	25
Annual IC Time Burden (Hours)	-70	70
Annual IC Cost Burden (Dollars)	-5,250	5,250

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.