Information Collection

Data Collection Form for Reporting on Audits of States, Local Governments, and Non-Profit Organizations

IC 791 under ICR 201604-0348-001 · OMB 0348-0057.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SF-SAC Instructions.pdf harvester.census.gov/fac	Instruction
Form SF-SAC Instructions_PILOT.pdf harvester.census.gov/fac	Instruction
0348-0057 SF-SAC Data Collection Form for Reporting on Audits Form SF-SAC.pdf harvester.census.gov/fac	Form
03148-0057 SF-SAC Pilot Template Form SF-SAC_PILOT.pdf harvester.census.gov	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
Instruction			Form SF-SAC Instructions.pdf	http://harvester.census.gov/fac	Yes	Yes	Printable Only
Instruction			Form SF-SAC Instructions_PILOT.pdf	http://harvester.census.gov/fac	Yes	Yes	Printable Only
Form	03148-0057	SF-SAC Pilot Template	Form SF-SAC_PILOT.pdf	http://harvester.census.gov	Yes	Yes	Fillable Fileable Signable
Form	0348-0057	SF-SAC Data Collection Form for Reporting on Audits	Form SF-SAC.pdf	http://harvester.census.gov/fac	Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 72,000

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	72,000	72,000
Annual IC Time Burden (Hours)	1,244,160	1,244,160
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.