Information Collection

ECSH Data Indicators

IC 223539 under ICR 201609-0970-003 · OMB 0970-0491.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 ECSH Data Indicators	Form and Instruction
1 ECSH Data Indicators for OMB-approval. The ECSH Data Ind FINAL ECSH Data Indicators.docx	Form and Instruction
HHS-2016-ACF-ORR-RE-1129_1.pdf FOA	IC Document

IC Title:

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	ECSH Data Indicators for OMB-approval. The ECSH Data Indicators	FINAL ECSH Data Indicators.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: 10

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
FOA	HHS-2016-ACF-ORR-RE-1129_1.pdf	09/14/2016

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