Information Collection

CFS-101, Parts I, II, and III

IC 184244 under ICR 201301-0970-009 · OMB 0970-0426.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0426 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 CFS-101, Parts I, II, and III	Form
CFS Part I Iinstructions FY12 02-11.doc	Instruction
CFS Part II Instructions FY12 02-11.doc	Instruction
CFS Part III Instructions FY12 02-11.doc	Instruction
1 Part II FY2012 CFS101 Part II R.xls	Form
CFS-101 Annual Budget Expenses Request and Est. Expenditures CFS-101 - 3-17-08.xls	Form
1 Part I FY2012 CFS101 Part I R.xls	Form
1 Part III FY2012 CFS101 Part III R.xls	Form

IC Title:

CFS-101, Parts I, II, and III

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 1357.16

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
Form	1	Part II	FY2012 CFS101 Part II R.xls	No	No	Printable Only
Form	CFS-101	Annual Budget Expenses Request and Est. Expenditures	CFS-101 - 3-17-08.xls	No	No	Printable Only
Form	1	Part I	FY2012 CFS101 Part I R.xls	No	No	Printable Only
Form	1	Part III	FY2012 CFS101 Part III R.xls	No	No	Printable Only
Instruction			CFS Part I Iinstructions FY12 02-11.doc	No	No	Printable Only
Instruction			CFS Part II Instructions FY12 02-11.doc	No	No	Printable Only
Instruction			CFS Part III Instructions FY12 02-11.doc	No	No	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 232

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	232	-43	275
Annual IC Time Burden (Hours)	1,016	-189	1,205
Annual IC Cost Burden (Dollars)	0	0	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.