Information Collection

TCP Disaster TA Intake Form

IC 272610 under ICR 202503-2105-003 · OMB 2105-0573.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2105-0573 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
TCP Disaster TA Intake Form	Form and Instruction
Thriving Communities Program Disaster Intake Form TCP Disaster TA Intake Form	Form and Instruction
Thriving Communities Program Disaster Intake Form FY 2025 Thriving Communities Program Disaster Intake Form_02-25-2025.docx	Form and Instruction
Thriving Communities Program Disaster Intake Form FY 2025 Thriving Communities Program Disaster Intake Form_02-25-2025.docx	Form and Instruction
Generic Clearance.SubmissionTemplate_PRA112124.docx Generic Template	IC Document
Generic Clearance.SubmissionTemplate_PRA112124.docx Generic Template	IC Document

IC Title:

TCP Disaster TA Intake Form

Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

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
Form and Instruction	N/A				Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

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 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Generic Template		11/22/2024

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

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