Information Collection

Childcare Application Form

IC 202019 under ICR 201508-3045-001 · OMB 3045-0142.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0142 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Childcare Application Form	Form and Instruction
1 Childcare Application w Privacy Statement Childcare Provider Application7.25.12.rtf www.nationalservice.gov	Form and Instruction

IC Title:

Childcare Application Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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	Childcare Application w Privacy Statement	Childcare Provider Application7.25.12.rtf	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: 2,250

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-2,250	2,250
Annual IC Time Burden (Hours)	-1,125	1,125
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.