Information Collection

Agriculture Evaluation Questionnaire

IC 229505 under ICR 202406-1035-001 · OMB 1035-0005.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Agriculture Questionnaire.docx itrs.ambvisualsolutions.com/Account/Login	Other-Screenshot: Agriculture Evalua
Preliminary System Screenshot as of 02162018.docx Screenshot of Primary Login Page	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation:

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
Other-Screenshot: Agriculture Evaluation			Agriculture Questionnaire.docx	https://itrs.ambvisualsolutions.com/Account/Login	Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title: Individual Indian Money (IIM) Trust Funds â Interior, OS-02

FR Citation: 80 FR 1043

Number of Respondents: 64

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	64	64
Annual IC Time Burden (Hours)	192	192
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Screenshot of Primary Login Page	Preliminary System Screenshot as of 02162018.docx	02/21/2018

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