Information Collection

Record Keeping Burden

IC 228667 under ICR 201710-0985-003 · OMB 0985-0042.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0042 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Record Keeping Burden Form
1 State Grant for AT Progress Report Reporting Form - State Grant for AT Annual Progress Report (APR) Data Instrument - Revised.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Record Keeping Burden	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	State Grant for AT Progress Report	Reporting Form - State Grant for AT Annual Progress Report (APR) Data Instrument - Revised.docx		Yes	Yes	Fillable Fileable

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: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	448	448
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.