Information Collection

OCSE Form 34-A

IC 180303 under ICR 201007-0970-008 · OMB 0970-0218.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0218 can be found here:

Documents and Forms

Document Name Document Type
Form OCSE 34A OCSE Form 34-A Form
OCSE 34A OCSE 34A 34A.pdf Form
Instructions OCSE34A FINAL 10-01-2007 with PRA Update (4).doc instructions IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	OCSE Form 34-A	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 309

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	OCSE 34A	OCSE 34A	34A.pdf		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: 49	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	196	196
Annual IC Time Burden (Hours)	1,568	1,568
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
instructions	Instructions OCSE34A FINAL 10-01-2007 with PRA Update (4).doc	07/12/2010

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.