Information Collection

General Testimony

IC 182929 under ICR 201910-0970-007 · OMB 0970-0085.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0085 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 General Testimony	Form
General Testimony Instructions 2019 Final 12112019.docx	Instruction
1 General Testimony General Testimony 2019 Final 12112019.docx	Form

IC Title:

General Testimony

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 303.7(a)(4)

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	1	General Testimony	General Testimony 2019 Final 12112019.docx		Yes	Yes	Fillable Printable
Instruction			General Testimony Instructions 2019 Final 12112019.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: 54

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	394,092	44,172	349,920
Annual IC Time Burden (Hours)	161,578	46,104	115,474
Annual IC Cost Burden (Dollars)	0	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.