Information Collection

1000.382 - Annual self-governance report

IC 190042 under ICR 201903-1076-007 · OMB 1076-0143.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0143 can be found here:

Documents and Forms

Document Name Document Type
1000.382 - Annual self-governance report Form
Self-Governance Minimum Data Collection 1076-0143 Form.doc 64.58.34.34/osg/default.aspx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	1000.382 - Annual self-governance report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 1000.382

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	Self-Governance Minimum Data Collection	1076-0143 Form.doc	http://64.58.34.34/osg/default.aspx	Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 33	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 30 %

	Approved	Previously Approved
Annual Number of Responses for this IC	33	33
Annual IC Time Burden (Hours)	2,112	2,112
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.