Baseline Questionnaire for Certified Local Governments (State)

Procedures for State, Tribal, and Local Government Historic Preservation Programs

Documents and Forms

Document Name Document Type
Form 10-2061 Baseline Questionnaire for Certified Local Governments (State) Form
10-2061 National Park Service Cumulative Baseline Questionnaire 10-2061 Baselline Questionaire for Certified Local Governments.pdf www.nps.gov/history/hps/clg/index.htm Form

Information Collection (IC) Details

IC Title:	Baseline Questionnaire for Certified Local Governments (State)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 36 CFR 61

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	10-2061	National Park Service Cumulative Baseline Questionnaire for CLGs	10-2061 Baselline Questionaire for Certified Local Governments.pdf	http://www.nps.gov/history/hps/clg/index.htm	Yes	No	Printable Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Requested	Previously Approved
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	188	188
Annual IC Cost Burden (Dollars)	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.