Information Collection

1924-A - State, Local and Tribal Government

IC 191596 under ICR 200911-0575-002 · OMB 0575-0042.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0575-0042 can be found here:

Documents and Forms

Document Name Document Type
Form RD 1924-07 1924-A - State, Local and Tribal Government Form
RD 1924-07 Contract Change Order 1924-07.pdf Form
RD 1924-09 Certificate of Contractor's Release 1924-09.pdf Form
RD 1924-10 Release by Claimants 1924-10.pdf Form
RD 1924-12 Inspection Report 1924-12.pdf Form
RD 1924-18 Partial Payment Estimate 1924-18.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	1924-A - State, Local and Tribal Government	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	RD 1924-07	Contract Change Order	1924-07.pdf	Yes	No	Fillable Printable
Form	RD 1924-09	Certificate of Contractor's Release	1924-09.pdf	Yes	No	Fillable Printable
Form	RD 1924-10	Release by Claimants	1924-10.pdf	Yes	No	Fillable Printable
Form	RD 1924-12	Inspection Report	1924-12.pdf	Yes	No	Fillable Printable
Form	RD 1924-18	Partial Payment Estimate	1924-18.pdf	Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	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 Agency Discretion
Annual Number of Responses for this IC	14,896	14,896
Annual IC Time Burden (Hours)	4,661	4,661
Annual IC Cost Burden (Dollars)	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.