Information Collection

Disadvantaged Business Enterprise Supportive Services (DBE/SS) Submissions

IC 260274 under ICR 202305-2125-001 · OMB 2125-0680.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
DBESS SOW Template.docx	Other-DBESS Statement of Work
DBESS SOW Template _5.3.24.docx	Other-DBESS Statement of Work
DBESS Accomplishment Report Form.docx	Other-DBESS Accomplishment Report
DBESS Accomplishment Report Form_5.3.2024.docx	Other-DBESS Accomplishment Report

IC Title:

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
Other-DBESS Statement of Work			DBESS SOW Template _5.3.24.docx		Yes	Yes	Fillable Fileable
Other-DBESS Accomplishment Report			DBESS Accomplishment Report Form_5.3.2024.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 53

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	53	53
Annual IC Time Burden (Hours)	212	212
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.