Information Collection

Obtain Access to Administrative Data - Private Sector

IC 209830 under ICR 201312-0970-003 · OMB 0970-0444.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0444 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
VIC Administrative Data Elements.pdf VIC Administrative Data Elements	IC Document

IC Title:

Obtain Access to Administrative Data - Private Sector

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 42 CFR B (To search for a specific CFR, visit the Code of Federal Regulations.)

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

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title: Records maintained on individuals

FR Citation: 5 FR 43

Number of Respondents: 9

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	9	9
Annual IC Time Burden (Hours)	384	384
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
VIC Administrative Data Elements	VIC Administrative Data Elements.pdf	12/09/2013

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