Information Collection

2015 752 OCS_CSGB_ACSI Survey of Eligible Entitities

IC 218022 under ICR 201412-1090-003 · OMB 1090-0007.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0007 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 752 2015 752 OCS_CSGB_ACSI Survey of Eligible Entitities	Form and Instruction
752 2015 752 OCS_CSBG_ACSI Survey of Eligible Entitites 2015 752 OCS_CSBG_ACSI Survey of Eligible Entities Final 8-26-15.docx	Form and Instruction
PRA supporting statement for CSBG Model State Plan FY2015.docx PRA Supporting Statement	IC Document
DCL_CSBG MSP OMB Clearance.docx DCL Clearance	IC Document
SUMM_Major Public Comments and the OCS Response Attachment A.docx Summary of Major Public Comments	IC Document
MSP_CSBG Model State Plan DRAFT attachment B.docx Model State Plan	IC Document
POL_CSBG State accountability measures DRAFT attachment C.docx State Accountability Measures	IC Document
FORM_OLDC Access Form attachment D.docx Access Form Attachment D	IC Document
CSBG Model State Plan PRA State Comments 2015.xlsx Model State Plan PRA Comments	IC Document

IC Title:

2015 752 OCS_CSGB_ACSI Survey of Eligible Entitities

Agency IC Tracking Number:

752

IC Status: New

Obligation to Respond: Voluntary

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	752	2015 752 OCS_CSBG_ACSI Survey of Eligible Entitites	2015 752 OCS_CSBG_ACSI Survey of Eligible Entities Final 8-26-15.docx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
PRA Supporting Statement	PRA supporting statement for CSBG Model State Plan FY2015.docx	08/26/2015
DCL Clearance	DCL_CSBG MSP OMB Clearance.docx	08/26/2015
Summary of Major Public Comments	SUMM_Major Public Comments and the OCS Response Attachment A.docx	08/26/2015
Model State Plan	MSP_CSBG Model State Plan DRAFT attachment B.docx	08/26/2015
State Accountability Measures	POL_CSBG State accountability measures DRAFT attachment C.docx	08/26/2015
Access Form Attachment D	FORM_OLDC Access Form attachment D.docx	08/26/2015
Model State Plan PRA Comments	CSBG Model State Plan PRA State Comments 2015.xlsx	08/26/2015

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