Information Collection

SHA/CCAA (Individual SHA Template) - Individuals

IC 225169 under ICR 202404-1018-003 · OMB 1018-0094.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2018_01_24_Individual SHA Template.docx Individual SHA Template	IC Document
2018_01_24_Individual SHA Template.docx Individual SHA Template	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 50 CFR 13 and 17

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

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title: Permits System--Interior, FWS-21

FR Citation: 68 FR 52610

Number of Respondents: 2

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-2	2
Annual IC Time Burden (Hours)	-60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Individual SHA Template	2018_01_24_Individual SHA Template.docx	10/08/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.