Information Collection

Freedom of Information Act (FOIA) Request for Assistance and Consent

IC 194856 under ICR 202606-3095-002 · OMB 3095-0068.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NA Form 10003 Consent to Make Inquiries and Release of Information and Records Freedom of Information Act (FOIA) Request for Assistance and Consent	Form and Instruction
NA Form 10003 Consent to Make Inquiries and Release of Information and na-10003_FINAL_08_19.pdf	Form and Instruction

IC Title:

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 and Instruction	NA Form 10003				Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records

Title: NARA 40

FR Citation: 75 FR 45674

Number of Respondents: 3,676

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	3,676	3,676
Annual IC Time Burden (Hours)	609	609
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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