Information Collection

Awardee Certifications and Disclosures

IC 249067 under ICR 202408-0417-001 · OMB 0417-0501.

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Information Collection (IC) Details

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IC Title:	Awardee Certifications and Disclosures	Agency IC Tracking Number:	IAF-06

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 2 CFR 200.112

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 450	Number of Respondents for Small Entity: 450

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Farms, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	450	440	10
Annual IC Time Burden (Hours)	90	75	15
Annual IC Cost Burden (Dollars)	1,404	1,174	230

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