Information Collection

Form OCSE-396A, "Quarterly Report of Expenditures"

IC 182113 under ICR 201707-0970-006 · OMB 0970-0181.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 396 Form OCSE-396A, "Quarterly Report of Expenditures"	Form
Instructions - Form OCSE-396 May 2017.pdf	Instruction
396 OCSE-396 Form OCSE-396 DRAFT May 2017.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 300

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	396	OCSE-396	Form OCSE-396 DRAFT May 2017.pdf		Yes	Yes	Fillable Printable
Instruction			Instructions - Form OCSE-396 May 2017.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: 0 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	216	216
Annual IC Time Burden (Hours)	1,296	1,296
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.