Information Collection

Child Care Case-Level Report

IC 9959 under ICR 201112-0970-003 · OMB 0970-0167.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0167 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ACF-801 Child Care Case-Level Report	Form and Instruction
ACF-801 Quarterly Case Record Report ACF-801 Form and Instructions Proposed Revisions (Final Version 2 0) 12-2.doc	Form and Instruction

IC Title:

Child Care Case-Level Report

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	ACF-801	Quarterly Case Record Report	ACF-801 Form and Instructions Proposed Revisions (Final Version 2 0) 12-2.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: 56

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	224	0	224
Annual IC Time Burden (Hours)	5,600	1,120	4,480
Annual IC Cost Burden (Dollars)	380,800	67,200	313,600

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.