Information Collection

93.093

IC 193280 under ICR 201403-0970-001 · OMB 0970-0139.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0139 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0124 and 0126 93.093	Form and Instruction
0124 and 0126 program announcement ACF-OFA-0124_Health Profession_Tribal.pdf	Form and Instruction
0124 and 0126 program announcement ACF-OFA-0126 Health Profession - TANF and Low-Income.pdf	Form and Instruction

IC Title:

93.093

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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 and Instruction	0124 and 0126	program announcement	ACF-OFA-0124_Health Profession_Tribal.pdf		Yes	Yes	Printable Only
Form and Instruction	0124 and 0126	program announcement	ACF-OFA-0126 Health Profession - TANF and Low-Income.pdf		Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 35

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	Previously Approved
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	2,100	2,100
Annual IC Cost Burden (Dollars)	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.