CAP Site Questionnaire Form

IMLS Collections Assessment for Preservation Forms

Documents and Forms

Document Name Document Type
Form CAP Site Questionn CAP Site Questionnaire Form Form and Instruction
CAP Site Questionn CAP Site Questionnaire Form 3137-0126 CAP Site Questionnaire_20240417.docx Form and Instruction
CAP Site Questionn CAP Site Questionnaire Form 3137-0126 CAP Site Questionnaire_20240417.docx Form and Instruction
CAP Site Questionnaire Form-20210309.docx FY21 CAP Site Questionnaire Form IC Document
CAP Site Questionnaire Form-20210309.docx FY21 CAP Site Questionnaire Form IC Document

Information Collection (IC) Details

IC Title:	CAP Site Questionnaire Form	Agency IC Tracking Number:

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	CAP Site Questionnaire Form 1	CAP Site Questionnaire Form	3137-0126 CAP Site Questionnaire_20240417.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 80

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	100	0	100
Annual IC Time Burden (Hours)	400	0	400
Annual IC Cost Burden (Dollars)	12,980	1,608	11,372

Documents for IC

Title	Document	Date Uploaded
FY21 CAP Site Questionnaire Form	CAP Site Questionnaire Form-20210309.docx	04/17/2024

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