Information Collection

OCSE Form 34-A

IC 180303 under ICR 201309-0970-006 · OMB 0970-0218.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0218 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OCSE 34A OCSE Form 34-A	Form
OCSE 34A OCSE 34A 34A.pdf	Form
Instructions OCSE34A FINAL 10-01-2007 with PRA Update (4).doc instructions	IC Document

IC Title:

OCSE Form 34-A

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 309

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	OCSE 34A	OCSE 34A	34A.pdf		No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 49

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
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-196	196
Annual IC Time Burden (Hours)	-1,568	1,568
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
instructions	Instructions OCSE34A FINAL 10-01-2007 with PRA Update (4).doc	07/12/2010

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