Information Collection

Self-Certification Eligibility Worksheet, Supplemental Planning and Demonstration Grants and Implementation Grants (300 Implementation Grants+ subset of 100 Supplemental Planning and Demonstration Gra

IC 264062 under ICR 202309-2125-001 · OMB 2125-0675.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OST Self-Certification Eligibility Worksheet, Supplemental Planning and Demonstration Grants and Implementation Grants (300 Implementation Grants+ subset of 100 Supplemental Planning and Demonstration Gra	Form and Instruction
OST Self-Certification Eligibility Worksheet Exhibit-E-SS4A-Self-Certification-Eligibility-Worksheet-FY23.pdf	Form and Instruction
OST Self-Certification Eligibility Worksheet Exhibit-E-SS4A-Self-Certification-Eligibility-Worksheet-FY23.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Self-Certification Eligibility Worksheet, Supplemental Planning and Demonstration Grants and Implementation Grants (300 Implementation Grants+ subset of 100 Supplemental Planning and Demonstration Gra

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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	OST	Self-Certification Eligibility Worksheet	Exhibit-E-SS4A-Self-Certification-Eligibility-Worksheet-FY23.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

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	400	400
Annual IC Time Burden (Hours)	200	200
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.