Information Collection

D3: Admin Data file submission with added fields

IC 211060 under ICR 201410-0970-003 · OMB 0970-0408.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0408 can be found here:

Documents and Forms

Document Name Document Type
Attachment D3 Administrative Data added fields.docx Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	D3: Admin Data file submission with added fields	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Attachment D3 Administrative Data added fields.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.