Information Collection

TITLE VI PROGRAM PERFORMANCE REPORT Part C

IC 234846 under ICR 201902-0985-001 · OMB 0985-0059.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0059 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
TITLE VI PROGRAM PERFORMANCE REPORT Part C	Form and Instruction
Title VI PPR Part C 0059 Title VI PPR Revision 3.4.19.docx	Form and Instruction

IC Title:

TITLE VI PROGRAM PERFORMANCE REPORT Part C

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Title VI PPR Part C	0059 Title VI PPR Revision 3.4.19.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: 237

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	237	237
Annual IC Time Burden (Hours)	393	393
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.