Information Collection

Family Planning Annual Report: Forms and Instructions

IC 10341 under ICR 201010-0990-004 · OMB 0990-0221.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0221 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0990-0221 Family Planning Annual Report: Forms and Instructions	Form and Instruction
0990-0221 Title X Family Planning Report 0990-0221C_FPAR_2011Version.pdf	Form and Instruction

IC Title:

Family Planning Annual Report: Forms and Instructions

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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 and Instruction	0990-0221	Title X Family Planning Report	0990-0221C_FPAR_2011Version.pdf		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 88

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	88	0	88
Annual IC Time Burden (Hours)	3,520	1,760	1,760
Annual IC Cost Burden (Dollars)	200,200	200,200	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.