Information Collection

State Self-Assessemtn Review and Report

IC 10061 under ICR 200011-0970-003 · OMB 0970-0223.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0223 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	State Self-Assessemtn Review and Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

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: 54	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	54	54
Annual IC Time Burden (Hours)	208,764	208,764
Annual IC Cost Burden (Dollars)	450,000	450,000

Documents for IC

Title	Document	Date Uploaded

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