Information Collection

Faith-Based Neighborhoods

IC 217801 under ICR 201603-1895-001 · OMB 1895-0001.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Faith-Based Neighborhoods	Form
Requirements Cost and Burden.docx	Other-Requirements
Beneficiary Rights and Referral Written Notice of Beneficiary Rights and Referral Request - clean.doc	Form

IC Title:

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	N/A	Beneficiary Rights and Referral	Written Notice of Beneficiary Rights and Referral Request - clean.doc		No		Paper Only
Other-Requirements			Requirements Cost and Burden.docx		No		Paper Only

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 542,829

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	542,829	542,829
Annual IC Time Burden (Hours)	19,163	19,163
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.