Voluntary Establishment of Paternity

ICR 200504-0970-005

OMB: 0970-0175

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
9975
Migrated
ICR Details
0970-0175 200504-0970-005
Historical Active 200105-0970-001
HHS/ACF
Voluntary Establishment of Paternity
Extension without change of a currently approved collection   No
Regular
Approved without change 06/21/2005
Retrieve Notice of Action (NOA) 04/20/2005
  Inventory as of this Action Requested Previously Approved
06/30/2008 06/30/2008 06/30/2005
862,043 0 6,905,480
143,099 0 76,059
0 0 0

Section 466(a)(5)(C) of the Social Security Act requires States to pass laws ensuring a simple civil process for voluntarily acknowledging paternity under which the State must provide that the mother and putative father must be given notice, orally and in writing, of the benefits and legal responsibilities and consequences of acknowledging paternity. The information is to be used by hospitals, birth record agencies, and other entities participating in the voluntary paternity establishment program.

None
None


No

1
IC Title Form No. Form Name
Voluntary Establishment of Paternity

  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 862,043 6,905,480 0 0 -6,043,437 0
Annual Time Burden (Hours) 143,099 76,059 0 0 67,040 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
04/20/2005


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