OSHS Cooperative Agreement

BLS/OSHS Cooperative Agreement (Application Package)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0149 can be found here:

Documents and Forms

Document Name Document Type
Form OSHS CA OSHS Cooperative Agreement Form and Instruction
BLS OSHS FRW BLS OSHS Financial Reconciliation Worksheet (FRW) OSHS FRW.pdf Form and Instruction
BLS OSHS Property BLS OSHS Property Listing OSHS Property Listing.pdf Form and Instruction
BLS OSHS TCF Transmittal and Certification Form OSHS TCF.pdf Form
BLS OSHS 2 BLS OSHS Quarterly Financial Report BLS-OSHS2.pdf Form and Instruction
OSHS CA 2013 OSHS Cooperative Agreement 2013 OSHS CA FINAL 5-7-2012.docx Form and Instruction

Information Collection (IC) Details

IC Title:	OSHS Cooperative Agreement	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OSHS CA	2013 OSHS Cooperative Agreement	2013 OSHS CA FINAL 5-7-2012.docx	Yes	Yes	Fillable Printable
Form and Instruction	BLS OSHS FRW	BLS OSHS Financial Reconciliation Worksheet (FRW)	OSHS FRW.pdf	Yes	Yes	Fillable Printable
Form and Instruction	BLS OSHS Property Listing	BLS OSHS Property Listing	OSHS Property Listing.pdf	Yes	Yes	Fillable Printable
Form	BLS OSHS TCF	Transmittal and Certification Form	OSHS TCF.pdf	Yes	Yes	Fillable Printable
Form and Instruction	BLS OSHS 2	BLS OSHS Quarterly Financial Report	BLS-OSHS2.pdf	Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	406	406
Annual IC Time Burden (Hours)	367	367
Annual IC Cost Burden (Dollars)	0	0

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.