Family Youth and Support Activities Application

Combined Federal Campaign

Documents and Forms

Document Name Document Type
Form OPM Form 1647-E Family Youth and Support Activities Application Form and Instruction
OPM Form 1647-E 2010 CFC FYSA Application 2010 FSYA Application.pdf www.opm.gov/cfc Form and Instruction
1647-E CFC FSYA OPM Form 1647-E (CLEAN VERSION).docx Form and Instruction

Information Collection (IC) Details

IC Title:	Family Youth and Support Activities Application	Agency IC Tracking Number:	1647- E

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 950.204(c)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OPM Form 1647-E	2010 CFC FYSA Application	2010 FSYA Application.pdf	www.opm.gov/cfc	Yes	No	Fillable Printable
Form and Instruction	1647-E	CFC FSYA	OPM Form 1647-E (CLEAN VERSION).docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	4,000	4,000

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.