Information Collection

Payment Request - State and Local Government

IC 203617 under ICR 201510-2060-006 · OMB 2060-0686.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2060-0686 can be found here:

Documents and Forms

Document Name Document Type
Form 5900-261 Payment Request - State and Local Government Form
5900-261 Payment Request 2015-ICR-Renewal-clean-diesel-rebate-payment - 10.27.15.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Payment Request - State and Local Government	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	5900-261	Payment Request	2015-ICR-Renewal-clean-diesel-rebate-payment - 10.27.15.pdf		Yes	Yes	Fillable Printable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 44	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	44	-6	50
Annual IC Time Burden (Hours)	110	-45	155
Annual IC Cost Burden (Dollars)	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.