Information Collection

Grants to States for Access and Visitation

IC 10033 under ICR 201204-0970-004 · OMB 0970-0204.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0204 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Grants to States for Access and Visitation	Form
1 2013-2015 State Spreadsheet FY 2013-2015 State Spread Sheet FINAL April 11 2012.xls	Form
Attachment A Revised AVSurvey March 11 2012 (16) FINAL.docx Access and Visitation Survey Instructions	IC Document

IC Title:

Grants to States for Access and Visitation

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 303

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	1	2013-2015 State Spreadsheet	FY 2013-2015 State Spread Sheet FINAL April 11 2012.xls		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: 54

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 60 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	54	0	54
Annual IC Time Burden (Hours)	864	54	810
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Access and Visitation Survey Instructions	Attachment A Revised AVSurvey March 11 2012 (16) FINAL.docx	04/23/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.