Information Collection

Protocol for Collecting Administrative Records

IC 206722 under ICR 201607-0970-002 · OMB 0970-0439.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Protocol for Collecting Administrative Records	Form and Instruction
1 Protocol for Collecting Administrative Records IC 9_Protocol for collecting administrative records_final.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	1	Protocol for Collecting Administrative Records	IC 9_Protocol for collecting administrative records_final.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 32

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	Previously Approved
Annual Number of Responses for this IC	32	11	21
Annual IC Time Burden (Hours)	256	85	171
Annual IC Cost Burden (Dollars)	0	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.