Certifications Regarding Lobbying; Debarment, Suspension

Application for Community Disaster Loan (CDL) Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0083 can be found here:

Documents and Forms

Document Name Document Type
Form FEMA Form 112-0-3C CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION Form
FEMA Form 112-0-3C CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION FEMA Form 112-0-3C Final version 11-7-2017.pdf Form

Information Collection (IC) Details

IC Title:	CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 44 CFR Part 18 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FEMA Form 112-0-3C	CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION	FEMA Form 112-0-3C Final version 11-7-2017.pdf		Yes	No	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records
Title: DHS/FEMA-009 - Hazard Mitigation Disaster Public Assistance and Disaster Loan Programs	FR Citation: 79 FR 16015

Number of Respondents: 28	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	28	28
Annual IC Time Burden (Hours)	12	12
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.