Information Collection

Customer Services Information Ques - Ind / Households

IC 194056 under ICR 201008-0970-001 · OMB 0970-0303.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0970-0303 Customer Services Information Ques - Ind / Households	Form
0970-0303 Appendix T_Customer Services Information Questions Appendix T_Customer Services Information Questions.doc	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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	0970-0303	Appendix T_Customer Services Information Questions	Appendix T_Customer Services Information Questions.doc		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,730

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 22 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,730	2,730
Annual IC Time Burden (Hours)	38	38
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.