Information Collection

ACF – 118A Part II (for medium and large tribes only)

IC 236353 under ICR 201905-0970-001 · OMB 0970-0198.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0198 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 ACF – 118A Part II (for medium and large tribes only)	Form and Instruction
1 CCDF Tribal Plan Preprint Attachment A - FY2020-2022 CCDF Tribal Plan Preprint PRA3_clean.docx	Form and Instruction

IC Title:

ACF â 118A Part II (for medium and large tribes only)

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	1	CCDF Tribal Plan Preprint	Attachment A - FY2020-2022 CCDF Tribal Plan Preprint PRA3_clean.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: 106

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	840	840
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.