Information Collection

Ocse-75

IC 178847 under ICR 201612-0970-009 · OMB 0970-0320.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0320 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OCSE-75 OCSE-75	Form and Instruction
OCSE-75 Annual Report OCSE-75 Form and Instructions for PRA 30 Day Process Dec 2016.docx	Form and Instruction
OCSE-75 AT for Extension of form 2016.docx OCSE-75 AT	IC Document

IC Title:

OCSE-75

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
Form and Instruction	OCSE-75	Annual Report	OCSE-75 Form and Instructions for PRA 30 Day Process Dec 2016.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: 63

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	Previously Approved
Annual Number of Responses for this IC	63	3	60
Annual IC Time Burden (Hours)	3,969	369	3,600
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OCSE-75 AT	OCSE-75 AT for Extension of form 2016.docx	12/22/2016

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