View Information Collection (IC)

View Information Collection (IC)

IC Title:	Tribal	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	AD-1047	Certification Regarding Debarrment, etc.	AD1047-F-01-92.pdf		Yes	No	Fillable Printable
Form	AD-1048	Certification Regarding Debarrment, etc. - Lower Tier	AD1048-F-01-92.pdf		Yes	No	Fillable Printable
Form	SF-270	Request for Advance or Reimbursement	sf270.pdf		Yes	No	Fillable Printable
Form	AD-1049	Certification for Drug-Free Workplace	AD1049-F-05-90.pdf		Yes	No	Fillable Printable
Form	SF-LLL	Disclosure of Lobbying Activites	sflllin.pdf		Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 126	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	347	0	0	221	0	126
Annual IC Time Burden (Hours)	419	0	0	248	0	171
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

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.