Supplemental Form to the Financial Status Report (SF269), Title III of the Older Americans Act, Grants for State and Community Programs on Aging

ICR 200106-0985-001

OMB: 0985-0004

Federal Form Document

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ICR Details
0985-0004 200106-0985-001
Historical Active 199909-0985-002
HHS/ACL
Supplemental Form to the Financial Status Report (SF269), Title III of the Older Americans Act, Grants for State and Community Programs on Aging
Revision of a currently approved collection   No
Regular
Approved without change 08/24/2001
Retrieve Notice of Action (NOA) 06/01/2001
  Inventory as of this Action Requested Previously Approved
08/31/2004 08/31/2004 08/31/2001
112 0 114
112 0 57
1,426,000 0 2,000

In order for the Administration on Aging to effectively monitor these program funds and to determine that these funds are used for the purpose for which allotments are made, specific financial data relating to program activities must be collected from the States.

None
None


No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 112 114 0 -2 0 0
Annual Time Burden (Hours) 112 57 0 55 0 0
Annual Cost Burden (Dollars) 1,426,000 2,000 0 1,424,000 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/01/2001


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