Information Collection

Cobalt

IC 183471 under ICR 202310-1028-003 · OMB 1028-0068.

Documents and Forms

Document Name Document Type
Form 9-4064-M Cobalt Form and Instruction
9-4064-M Cobalt 9-4064-M.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cobalt	Agency IC Tracking Number:	9-4064-M

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	9-4064-M	Cobalt	9-4064-M.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 30 %

	Requested	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	120	0	0	120
Annual IC Time Burden (Hours)	60	-120	60	120
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

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.