Water Technical Assistance Request Form & Needs Assessment

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Renewal)

Documents and Forms

Document Name Document Type
Form 6100-078 Water Technical Assistance Request Form & Needs Assessment Form and Instruction
6100-078 Water TA Request Form & Needs Assessment Form 6100-078, Water TA Request Form & Needs Assessment.docx Form and Instruction
6100-078 Water TA Request Form & Needs Assessment Form 6100-078, Water TA Request Form & Needs Assessment.docx Form and Instruction
Justification Water TA IC.docx IC Justification Document IC Document
Justification Water TA IC.docx IC Justification Document IC Document

Information Collection (IC) Details

IC Title:	Water Technical Assistance Request Form & Needs Assessment	Agency IC Tracking Number:	2434.249

IC Status: New

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	6100-078	Water TA Request Form & Needs Assessment	Form 6100-078, Water TA Request Form & Needs Assessment.docx		Yes	Yes	Fillable Fileable

Line of Business: Natural Resources

Subfunction: Water Resource Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
IC Justification Document	Justification Water TA IC.docx	06/28/2024

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