Information Collection

Fvpsa Tribal Performance Report

IC 186809 under ICR 201711-0970-006 · OMB 0970-0280.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0280 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 FVPSA TRIBAL PERFORMANCE REPORT	Form
1 NewFVPSAStateTribalPPR NewFVPSAStateTribalPPRforOMBreviewver2.docx	Form

IC Title:

FVPSA TRIBAL PERFORMANCE REPORT

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 1370

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	1	NewFVPSAStateTribalPPR	NewFVPSAStateTribalPPRforOMBreviewver2.docx		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: 150

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	150	150
Annual IC Time Burden (Hours)	1,500	1,500
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.