Information Collection

CFS-101, Parts I, II, and III

IC 184244 under ICR 200803-0980-002 · OMB 0980-0047.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0980-0047 can be found here:

Documents and Forms

Document Name Document Type
Form CFS-101 CFS-101, Parts I, II, and III Form
CFS-101 CFS-101 CFS-101 - 3-17-08.xls Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CFS-101, Parts I, II, and III	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 1357.16

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CFS-101	CFS-101	CFS-101 - 3-17-08.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: 275	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	275	275
Annual IC Time Burden (Hours)	1,205	1,205
Annual IC Cost Burden (Dollars)	0	0

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.