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CSBG Model Plan Application - States and Territories
Community Services Block Grant (CSBG) Program Model Plan Applications
OMB: 0970-0382
IC ID: 192928
OMB.report
HHS/ACF
OMB 0970-0382
ICR 201705-0970-008
IC 192928
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0382 can be found here:
2024-07-12 - Revision of a currently approved collection
2023-02-23 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
CSBG Model Plan Application - States and Territories
Form
DRAFT CSBG State accountability measures - attachment D.docx
Instruction
1 CSBG State Plan Information Collection Instrument
CSBG State Plan information collection instrument - attachment C_052417.docx
Form
CSBG State Plan Comments from 60-day notice - attachment B.xlsx
CSBG State Plan Comments
IC Document
GDL_Accessing CSBG Model State Plan in OLDC.pdf
GDL Accessing CSBG Model Plan in OLDC
IC Document
Section 676(b) of the CSBG Act - attachment A.docx
Sec. 676(b) of the CSBG Act
IC Document
DRAFT CSBG State accountability measures - attachment D.docx
DRAFT CSBG State Accountability Measures
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
CSBG Model Plan Application - States and Territories
Agency IC Tracking Number:
ocs
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
1
CSBG State Plan Information Collection Instrument
CSBG State Plan information collection instrument - attachment C_052417.docx
Yes
Yes
Fillable Printable
Instruction
DRAFT CSBG State accountability measures - attachment D.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
56
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
56
0
0
0
0
56
Annual IC Time Burden (Hours)
1,848
0
0
0
0
1,848
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
CSBG State Plan Comments
CSBG State Plan Comments from 60-day notice - attachment B.xlsx
05/27/2015
GDL Accessing CSBG Model Plan in OLDC
GDL_Accessing CSBG Model State Plan in OLDC.pdf
05/27/2015
Sec. 676(b) of the CSBG Act
Section 676(b) of the CSBG Act - attachment A.docx
05/27/2015
DRAFT CSBG State Accountability Measures
DRAFT CSBG State accountability measures - attachment D.docx
05/27/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.