Information Collection

Financial Status Reporting Form for Program of State Council on Developmental Disabilities

IC 10206 under ICR 200904-0980-001 · OMB 0980-0212.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ADD-02B Financial Status Report Financial Status Reporting Form for Program of State Council on Developmental Disabilities	Form and Instruction
ADD-02B Financial Status Report SCDD-ADD02B-08-Inst.doc	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 1386

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	ADD-02B				Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 55

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	165	110	55
Annual IC Time Burden (Hours)	842	402	440
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.

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