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Payment File
Federal Tax Offset, Administrative Offset, and Passport Denial Programs
OMB: 0970-0161
IC ID: 9939
OMB.report
HHS/ACF
OMB 0970-0161
ICR 200704-0970-003
IC 9939
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0161 can be found here:
2022-04-04 - Revision of a currently approved collection
2019-05-21 - Revision of a currently approved collection
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
Federal Enterprise Architecture Business Reference Module
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 New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,404
0
-5,670
0
0
7,074
Annual IC Time Burden (Hours)
379
0
-2,156
0
0
2,535
Annual IC Cost Burden (Dollars)
0
0
-128,000
0
0
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.