Information Collection

Child Support Agency Confidenial Information Form

IC 222797 under ICR 201608-0970-001 · OMB 0970-0085.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0085 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Child Support Agency Confidenial Information Form	Form and Instruction
1 Child Support Agency Confidential Information Child Support Agency Confidential_Information_Form_final.pdf	Form and Instruction

IC Title:

Child Support Agency Confidenial Information Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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 and Instruction	1	Child Support Agency Confidential Information	Child Support Agency Confidential_Information_Form_final.pdf		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: 54

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,029,536	2,029,536
Annual IC Time Burden (Hours)	101,477	101,477
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.