Information Collection

Request for State Data Needed to Determine the Amount of a Tribal Family Assistance Grant

IC 9969 under ICR 201009-0970-005 · OMB 0970-0173.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
StDataReqLtr-07.doc	Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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
Instruction			StDataReqLtr-07.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: 4

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	4	-11	15
Annual IC Time Burden (Hours)	168	-462	630
Annual IC Cost Burden (Dollars)	0	-80,000	80,000

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.