Multipurpose Reimbursement Checklist -- Other than Certified Cost or Pricing Data Required

Requests for Reimbursement under Section 3610 of the CARES Act

Documents and Forms

Document Name Document Type
TAB A2 - Multipurpose Reimb Checklist - 2020-OZZZZ 08.11.20 Final.docx Instruction
TAB A2 - Multipurpose Reimb Checklist - 2020-OZZZZ 08.11.20 Final.docx Instruction

Information Collection (IC) Details

IC Title:	Multipurpose Reimbursement Checklist -- Other than Certified Cost or Pricing Data Required	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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
Instruction			TAB A2 - Multipurpose Reimb Checklist - 2020-OZZZZ 08.11.20 Final.docx		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,965	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,965	2,965
Annual IC Time Burden (Hours)	237,200	237,200
Annual IC Cost Burden (Dollars)	13,463,472	13,463,472

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.