Information Collection

CHIPS Recipient Reporting

IC 269804 under ICR 202407-0693-002 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instruments will be added when the CHIPS Program Office has them finalized.pdf	Other-Collection Instrument
Instruments will be added when the CHIPS Program Office has them finalized.pdf	Other-Collection Instrument

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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-Collection Instrument			Instruments will be added when the CHIPS Program Office has them finalized.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	360	360
Annual IC Time Burden (Hours)	5,760	5,760
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.