Annual Certification - Qualified Nonprofit Agency Serving People Who Are Blind

Documents and Forms

Document Name Document Type
Form 403 Annual Certification - Qualified Nonprofit Agency Serving People Who Are Blind Form
403-Instructions 2012.docx Instruction
403 Annual Certification -Qualified Nonprofit Agency Serving 403 Form 2012.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Annual Certification - Qualified Nonprofit Agency Serving People Who Are Blind	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	403	Annual Certification -Qualified Nonprofit Agency Serving People Who Are Blind	403 Form 2012.docx		Yes	No	Paper Only
Instruction			403-Instructions 2012.docx		Yes	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 70	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	70	70
Annual IC Time Burden (Hours)	420	420
Annual IC Cost Burden (Dollars)	12,600	12,600

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.