Information Collection

Cooperation Required Of Afdc Applicants And Recipients In Pursuing Third Parties Who May Be Liable To Pay For Title Xix Care And Services

IC 116001 under ICR 199103-0970-001 · OMB 0970-0113.

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Information Collection (IC) Details

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IC Title:	COOPERATION REQUIRED OF AFDC APPLICANTS AND RECIPIENTS IN PURSUING THIRD PARTIES WHO MAY BE LIABLE TO PAY FOR TITLE XIX CARE AND SERVICES	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,200,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,200,000	3,200,000
Annual IC Time Burden (Hours)	533,000	533,000
Annual IC Cost Burden (Dollars)	0	0

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