View Information Collection (IC)
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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Payment Request Web Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
Form 1
Request for Advance or Reimbursement Web Form
IMLS 3137-0124 Payment Request Form Interface 20240131.docx
https://grants.imls.gov/Reach/
Yes
Yes
Fillable Printable
Instruction
IMLS 3137-0124 Payment Request Form Instructions 20240131.pdf
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Education
Subfunction:
Cultural and Historic Preservation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
6,000
Number of Respondents for Small Entity:
2,000
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
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
6,000
0
1,000
0
0
5,000
Annual IC Time Burden (Hours)
6,000
0
1,000
0
0
5,000
Annual IC Cost Burden (Dollars)
190,800
0
45,300
0
0
145,500
Documents for IC
Title
Document
Date Uploaded
How to Submit a Payment Request in eGMS Reach
reach_how_to_submit_a_payment_request.pdf
01/14/2021
Burden Estimate
Payment Request Burden Estimate 20201215.xlsx
01/14/2021
Payment Request Web Form
IMLS Request for Advance or Reimb Web Form 20200108.docx
02/07/2024
Burden Estimate FY2024
IMLS 3137-0124 Payment Request Form Burden Estimate 20240201.xlsx
02/07/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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