Information Collection

Complete Application

IC 221995 under ICR 201909-0970-007 · OMB 0970-0307.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0307 can be found here:

Documents and Forms

Document Name Document Type
1- CIP Program Instruction_11.22.19.docx Instruction
1 CIP Strategic Plan Template 1- CIP Strategic Plan Template_11.22.19.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Complete Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Instruction			1- CIP Program Instruction_11.22.19.docx		Yes	Yes	Fillable Fileable
Form	1	CIP Strategic Plan Template	1- CIP Strategic Plan Template_11.22.19.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: 52	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	52	0	52
Annual IC Time Burden (Hours)	2,704	624	2,080
Annual IC Cost Burden (Dollars)	0	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.