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Federal forms, ICRs, and supporting documents

Information Collection

Annual Representations and Certification

IC 217811 under ICR 202411-3037-002 · OMB 3037-0013.

Documents and Forms
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Form and Instruction
Form and Instruction
Form and Instruction
IC Document
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Information Collection (IC) Details

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Annual Representations and Certification 0013
 
Yes Removed
 
Mandatory
 
41 CFR 51-4.3  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Reps and Certs Annual Reps and Certs Annual Reps and Certs Form 7_27_15.doc Yes No Printable Only

Community and Social Services Social Services

Annual Representations and Certification  80 FR 27930

559 559
   
Private Sector Not-for-profit institutions
 
   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 0 0 -559 0 559 0
Annual IC Time Burden (Hours) 0 0 -4,472 0 4,472 0
Annual IC Cost Burden (Dollars) 0 0 -178,880 0 178,880 0

Title Document Date Uploaded
Supporting Document Supporting Statement annual reps and certs.docx 08/10/2015
Public Comments Public Comment.docx 08/10/2015
Fact Sheets Reps Certs Fact Sheet.docx 08/10/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.