Information Collection

Brief Contacts

IC 181168 under ICR 201009-0970-006 · OMB 0970-0123.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0123 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Brief Contacts Form and Instruction
1 Brief Contact Brief Contact.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Brief Contacts	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Brief Contact	Brief Contact.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: 572	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	101,244	100,172	1,072
Annual IC Time Burden (Hours)	15,187	14,651	536
Annual IC Cost Burden (Dollars)	379,665	366,265	13,400

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.