Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Annual Affidavit of No Change New 30000 45000 0
Percentages of DBEs in Various Categories New 52 161 0
Personal Net Worth Form New 9500 19000 0 Form and Instruction Appendix G Personal Net Worth Statement
Report of DBE Awards and Commitments Modified 1800 9000 0 Form DOT Form 4630 Uniform Report of DBE Awards/Commitments and Payments
Uniform Certification Application Form New 9500 76000 0 Form and Instruction Appendix F Certification Application For Internal Coordination
Total burden requested under this ICR: 50852 149161 0  
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