Information Collection

FRF Authorization Agreement for Preauthorized Payments Form

IC 200585 under ICR 202505-1505-001 · OMB 1505-0245.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TDF 105.1 FRF Authorization Agreement for Preauthorized Payments Form	Form and Instruction
Form TDF 105.1 Authorization Agreement for Preauthorized Payments FRF Authorization Agreement for Preauthorized Payments Form	Form and Instruction
TDF 105.1 Authorization Agreement for Preauthorized Payments TDF 105-1 rev_07-15.pdf	Form and Instruction
TDF 105.1 Authorization Agreement for Preauthorized Payments TDF 105-1 rev_07-15.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 150

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	TDF 105.1				Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 21

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	21	4	17
Annual IC Time Burden (Hours)	5	1	4
Annual IC Cost Burden (Dollars)	0	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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