Information Collection

Payment File

IC 9939 under ICR 200704-0970-003 · OMB 0970-0161.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0161 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Payment File Form and Instruction
1 payment file PRA Offset part2 Worksheet Offset_pymt file 3-23-07.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Payment File	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	payment file	PRA Offset part2 Worksheet Offset_pymt file 3-23-07.doc		No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: Location and Collection System	FR Citation: 70 FR 21200

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,404	-5,670	7,074
Annual IC Time Burden (Hours)	379	-2,156	2,535
Annual IC Cost Burden (Dollars)	0	-128,000	128,000

Documents for IC

Title	Document	Date Uploaded
No associated records found

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