Information Collection

SIF Pay for Success Application Instructions

IC 214767 under ICR 201501-3045-003 · OMB 3045-0167.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 SIF Pay for Success Application Instructions SIF Pay for Success Application Instructions	Form and Instruction
Form 2 SIF Pay for Success Application Instructions Appendix SIF Pay for Success Application Instructions	Form and Instruction
1 SIF Pay for Success Application Instructions 2015 SIF PFS Application Instructions 3.12.15.docx	Form and Instruction
2 SIF Pay for Success Application Instructions Appendix SIF PFS App Instructions Appendix B 011515.xlsx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	1			www.nationalservice.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	2			www.nationalservice.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

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	50	50
Annual IC Time Burden (Hours)	1,200	1,200
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.

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