Certification Form Page 4
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4Public Reporting Burden Statement
Paperwork Reduction Act Notice. Under the Paperwork Reduction Act, a person is not required to respond to a collection
of information unless it displays a current valid OMB control number. We try to create forms and instructions that are
accurate, can be easily understood, and which impose the least possible burden on you to provide us with information.
The estimated minimum average time to complete and file this application is 20 minutes per form. If you have any
comments regarding the accuracy of this estimate, or suggestions for making this form simpler, you can write to the
Office of Justice Programs, 810 7th Street, N.W., Washington, D.C. 20531.
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