Information Collection

Grants to States for Access and Visitation (Local Service Providers)

IC 187256 under ICR 200811-0970-002 · OMB 0970-0204.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0204 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Grants to States for Access and Visitation (Local Service Providers) Form and Instruction
1 Local Services Providers Form RevisedPartIILocalServiceProviderSurveyFINAL JULY 2008.doc Form and Instruction
1 Print Copy of LOCAL AV SURVEY Feb 26 Print Copy of Local AV Survey Spreadsheet.xls Form
1 Local Service Provider Survey RevisedPartIILocalServiceProviderSurveyFINAL JULY 2008.doc Form and Instruction
1 Print Copy of Local AV Survey Spreadsheet April 24 Print Copy of Local AV Survey Spreadsheet (2).xls Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Grants to States for Access and Visitation (Local Service Providers)	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 303

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Local Services Providers Form	RevisedPartIILocalServiceProviderSurveyFINAL JULY 2008.doc	Yes	Yes	Printable Only
Form	1	Print Copy of LOCAL AV SURVEY	Feb 26 Print Copy of Local AV Survey Spreadsheet.xls	Yes	No	Fillable Printable
Form and Instruction	1	Local Service Provider Survey	RevisedPartIILocalServiceProviderSurveyFINAL JULY 2008.doc	Yes	Yes	Fillable Printable
Form	1	Print Copy of Local AV Survey Spreadsheet	April 24 Print Copy of Local AV Survey Spreadsheet (2).xls	Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 260	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	260	260
Annual IC Time Burden (Hours)	3,900	3,900
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.