Information Collection

Report Of Claims Of Good Cause For Refusing To Cooperate In Establishing Paternity And Securing Child Support

IC 115938 under ICR 199101-0970-001 · OMB 0970-0073.

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Documents and forms in this information collection
Document Name	Document Type

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IC Title:

REPORT OF CLAIMS OF GOOD CAUSE FOR REFUSING TO COOPERATE IN ESTABLISHING PATERNITY AND SECURING CHILD SUPPORT

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FSA-4680				No	No
Form	FSA-4681				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 54

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	10,086	10	10,076
Annual IC Time Burden (Hours)	2,527	2	2,525
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.