Information Collection

State, Local or Tribal

IC 186489 under ICR 201111-0970-009 · OMB 0970-0353.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
RPG Data Dictionary.pdf	Other-data dictionary
Final Data Submission Plans Instructions 2011.docx	Instruction
0 survey Data Plan Sample.pdf	Form

IC Title:

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-data dictionary			RPG Data Dictionary.pdf	No	No	Paper Only
Form	0	survey	Data Plan Sample.pdf	Yes	Yes	Fillable Printable
Instruction			Final Data Submission Plans Instructions 2011.docx	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: 26

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	52	-10	62
Annual IC Time Burden (Hours)	9,126	-1,755	10,881
Annual IC Cost Burden (Dollars)	89,076	-17,130	106,206

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.