Information Collection

Notice of Lien

IC 9914 under ICR 200801-0970-003 · OMB 0970-0153.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0153 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Notice of Lien	Form and Instruction
1 Notice of Lien lien_final.pdf	Form and Instruction

IC Title:

Notice of Lien

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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 and Instruction	1	Notice of Lien	lien_final.pdf		No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 123,637

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	123,637	123,636	1
Annual IC Time Burden (Hours)	30,909	3,563	27,346
Annual IC Cost Burden (Dollars)	0	0	0

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.