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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.