Information Collection

FY2019 Coordinated Tribal Assistance

IC 236783 under ICR 201606-1103-003 · OMB 1103-0117.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1103-0117 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1103-0117 FY2019 Coordinated Tribal Assistance	Form and Instruction
1103-0117 FY2019 Coordinated Tribal Assistance CTAS Assessment 1103-0117.docx	Form and Instruction
OMB# 1103-0117 Generic Clearance Submission Template CTAS.docx Fiscal Year (FY) 2019 Coordinated Tribal Assistance Solicitation Assessment	IC Document

IC Title:

FY2019 Coordinated Tribal Assistance

Agency IC Tracking Number:

1103-0117

IC Status: New

Obligation to Respond: Voluntary

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	1103-0117	FY2019 Coordinated Tribal Assistance	CTAS Assessment 1103-0117.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	200	200
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fiscal Year (FY) 2019 Coordinated Tribal Assistance Solicitation Assessment	OMB# 1103-0117 Generic Clearance Submission Template CTAS.docx	07/11/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.