Information Collection

Long Format for Applicants

IC 9825 under ICR 200803-0970-010 · OMB 0970-0060.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0060 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Applicant '09 Long Format for Applicants	Form
Form 1 Long Format Applicants '10 Long Format for Applicants	Form
Form 1 Long Applicant '08 Long Format for Applicants	Form
1 Applicant '09 hhsrptst09_applicant.xls	Form
1 Long Format Applicants '10 hhsrptst10_applicant.xls	Form
1 Long Applicant '08 hhsrptst08_applicant.xls	Form

IC Title:

Long Format for Applicants

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Applicant '09	hhsrptst09_applicant.xls	No	No	Paper Only
Form	1	Long Format Applicants '10	hhsrptst10_applicant.xls	No	No	Paper Only
Form	1	Long Applicant '08	hhsrptst08_applicant.xls	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: 52

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 70 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	52	52
Annual IC Time Burden (Hours)	676	676
Annual IC Cost Burden (Dollars)	2,236	2,236

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.