Information Collection

Supplemental Form to the Financial Status Report (SF-269), Title III of the Older Americans Act, Grants for State and Community Programs on Aging

IC 10241 under ICR 199803-0985-001 · OMB 0985-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0004 can be found here:

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Information Collection (IC) Details

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IC Title:	Supplemental Form to the Financial Status Report (SF-269), Title III of the Older Americans Act, Grants for State and Community Programs on Aging	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: 57	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
Annual Number of Responses for this IC	114	114
Annual IC Time Burden (Hours)	57	57
Annual IC Cost Burden (Dollars)	1,497,000	1,497,000

Documents for IC

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