NONDISCRIMINATION ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN AND ARE IN FEDERALLY ASSISTED PROGRAMS OF THE DEPARTMENT OF THE DEPARTMENT OF THE INTERIOR
ICR 198703-1084-005
OMB: 1084-0021
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1084-0021 can be found here:
NONDISCRIMINATION ON THE
BASIS OF RACE, COLOR, NATIONAL ORIGIN AND ARE IN FEDERALLY ASSISTED
PROGRAMS OF THE DEPARTMENT OF THE DEPARTMENT OF THE INTERIOR
THIS RECORDKEEPING REQUIREMENT IS
NEEDED TO PROVIDE A BASIS FOR PROGRAM PLANNING AND EVALUATION OF
RECIPIENT COMPLIANCE WI THE REQUIREMENTS OF TITLE 6 OF THE CIVIL
RIGHTS ACT OF 1984.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.