Information Collection

Rural/Tribal

IC 258617 under ICR 202504-2105-001 · OMB 2105-0584.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2105-0584 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Version 1 Rural/Tribal	Form
Form Version 1 Rural and Tribal Grant Application For Rural/Tribal	Form
Version 1 Rural and Tribal Grant Application For Rural and Tribal Grant Application Form template 12 21 22.pdf	Form
Version 1 Rural and Tribal Grant Application For Rural and Tribal Grant Application Form template 12 21 22.pdf	Form

IC Title:

Rural/Tribal

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	Version 1				Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	228	228
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.

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