Information Collection

Order/Notice to Withhold Income for Child Support

IC 9917 under ICR 200012-0970-007 · OMB 0970-0154.

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Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Order/Notice to Withhold Income for Child Support

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

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	N/A				Yes	Yes

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: 93 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	54	0	-1,573,272	1,573,326
Annual IC Time Burden (Hours)	16,056	0	-72,085	88,141
Annual IC Cost Burden (Dollars)	0	-22,000	0	22,000

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.

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