Information Collection

Case Plan Requirement Sections 422, 471 and 475 of te Social Security Act

IC 10176 under ICR 201112-0980-001 · OMB 0980-0140.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 AFCARS Case Plan Requirement Sections 422, 471 and 475 of te Social Security Act	Form and Instruction
1 AFCARS State Plan Pre-print 1-12-07 Final Highlighted 9-25-07.doc	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 1356

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	1				Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 604,453

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	604,453	1,000	603,453
Annual IC Time Burden (Hours)	3,022,265	131,725	2,890,540
Annual IC Cost Burden (Dollars)	43,520,616	43,520,616	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.

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