Information Collection

Disclosures required incremental to Government-supplied language

IC 192051 under ICR 201112-3084-003 · OMB 3084-0157.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3084-0157 can be found here:

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Information Collection (IC) Details

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IC Title:	Disclosures required incremental to Government-supplied language	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 16 CFR 322

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 238

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 55 %

	Approved	Program Change Due to New Statute	Previously Approved
Annual Number of Responses for this IC	250	-250	500
Annual IC Time Burden (Hours)	500	-500	1,000
Annual IC Cost Burden (Dollars)	250,000	-250,000	500,000

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.