Information Collection

Complaint Procedures for State-Administered Programs/IASA and Public Notification of Procedures

IC 21275 under ICR 199705-1810-001 · OMB 1810-0591.

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Information Collection (IC) Details

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IC Title:	Complaint Procedures for State-Administered Programs/IASA and Public Notification of Procedures	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: 17,057	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	18,140	18,120	20
Annual IC Time Burden (Hours)	140,560	136,000	4,560
Annual IC Cost Burden (Dollars)	920,000	681,000	239,000

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Title	Document	Date Uploaded

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