Information Collection

Faith-Based Neighborhoods

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

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Faith-Based Neighborhoods	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:

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 %

	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

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.