Information Collection

OSHS Cooperative Agreement

IC 215287 under ICR 201706-1220-001 · OMB 1220-0149.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0149 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OSHS CA OSHS Cooperative Agreement	Form and Instruction
OSHS CA OSHS FY2018 CA Final Draft OSHS FY 2018 Draft CA.docx	Form and Instruction
BLS OSHS2 Quarterly Financial Report BLS OSHS2 - Quarterly Financial Report.docx	Form and Instruction
FRW Financial Reconciliation Worksheet FRW - Financial Reconciliation Worksheet.docx	Form and Instruction
OSHS TCF Transmittal and Certification Form Transmittal and Certification Form.docx	Form
BLS OSHS PL OSHS Property Listing OSHS Property Listing.docx	Form and Instruction

IC Title:

OSHS Cooperative Agreement

Agency IC Tracking Number:

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OSHS CA	OSHS FY2018 CA	Final Draft OSHS FY 2018 Draft CA.docx	Yes	No	Printable Only
Form and Instruction	BLS OSHS2	Quarterly Financial Report	BLS OSHS2 - Quarterly Financial Report.docx	Yes	No	Printable Only
Form and Instruction	FRW	Financial Reconciliation Worksheet	FRW - Financial Reconciliation Worksheet.docx	Yes	Yes	Fillable Printable
Form	OSHS TCF	Transmittal and Certification Form	Transmittal and Certification Form.docx	Yes	Yes	Fillable Printable
Form and Instruction	BLS OSHS PL	OSHS Property Listing	OSHS Property Listing.docx	Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

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: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	406	406
Annual IC Time Burden (Hours)	367	367
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.