Information Collection

Financial Status Reporting Form (SF-269) with Supplemental Form (ADD-02) for porogam of state council on developmental disabilities

IC 10205 under ICR 200207-0980-004 · OMB 0980-0212.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0980-0212 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Financial Status Reporting Form (SF-269) with Supplemental Form (ADD-02) for porogam of state council on developmental disabilities

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ADD02/SF269				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 55

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	110	110
Annual IC Time Burden (Hours)	990	990
Annual IC Cost Burden (Dollars)	0	0

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.