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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.