Information Collection

Tracking the $25 Fee

IC 182889 under ICR 200711-0970-003 · OMB 0970-0017.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0017 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Tracking the $25 Fee	Form and Instruction
1 Tracking the $25 fee OCSE 21 U4 transmittal slip 11152007.doc	Form and Instruction

IC Title:

Tracking the $25 Fee

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 302.a

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 and Instruction	1	Tracking the $25 fee	OCSE 21 U4 transmittal slip 11152007.doc		No	No	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 54

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 New Statute
Annual Number of Responses for this IC	54	54
Annual IC Time Burden (Hours)	135	135
Annual IC Cost Burden (Dollars)	163	163

Documents for IC

table that charts IC Documents
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.