Information Collection

FVPSA Coalition PPR

IC 212203 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⚠️ Notice: This information collection may be referencing outdated material.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 Coalition PPR	Form
1 CoalitionPPR CoalitionPPR-OMBSept2017.docx	Form

IC Title:

FVPSA Coalition PPR

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	CoalitionPPR	CoalitionPPR-OMBSept2017.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: 56

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

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	56	56
Annual IC Time Burden (Hours)	560	560
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.