Information Collection

Interest Payment Form

IC 198536 under ICR 202301-3045-004 · OMB 3045-0053.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0053 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Interest Payment Form	Form and Instruction
Interest Payment Form_2020-2023 REDLINED.docx	Other-REDLINED
Interest Payment Form_2020-2023 REDLINED.docx	Other-REDLINED
1 Interest Accrual Form 20230127 Interest Payment Form1_2023.docx www.nationalservice.gov	Form and Instruction
1 Interest Accrual Form 20230127 Interest Payment Form1_2023.docx www.nationalservice.gov	Form and Instruction

IC Title:

Interest Payment Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	1	Interest Accrual Form	20230127 Interest Payment Form1_2023.docx	www.nationalservice.gov	Yes	Yes	Fillable Fileable
Other-REDLINED			Interest Payment Form_2020-2023 REDLINED.docx		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: 320

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 66 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	320	-12,880	13,200
Annual IC Time Burden (Hours)	27	-1,073	1,100
Annual IC Cost Burden (Dollars)	1,117	1,117	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.