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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form 1 FVPSA Coalition PPR Form
1 CoalitionPPR CoalitionPPR-OMBSept2017.docx Form

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.