Information Collection

State IV-D Ageny: Manual Entry of Couirt Provided Case Information

IC 211789 under ICR 201707-0970-007 · OMB 0970-0421.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0421 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 State IV-D Ageny: Manual Entry of Couirt Provided Case Information	Form and Instruction
1 input transaction 0970-0421_FCR App G Input Transactions.doc	Form and Instruction

IC Title:

State IV-D Ageny: Manual Entry of Couirt Provided Case Information

Agency IC Tracking Number:

ocse

Is this a Common Form? No

IC Status: Removed

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	input transaction	0970-0421_FCR App G Input Transactions.doc		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
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-769,662	769,662
Annual IC Time Burden (Hours)	-25,655	25,655
Annual IC Cost Burden (Dollars)	-3,362,450	3,362,450

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.