Information Collection

Declaration in Support of Establishing Parentage

IC 222799 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⚠️ Notice: This information collection may be referencing outdated material.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 Declaration in Support of Establishing Parentage	Form and Instruction
1 Declaration in Support of Establishing Parentage Declaration in Support of Establishing Parentage 2019 Final 12112019.docx	Form and Instruction

IC Title:

Declaration in Support of Establishing Parentage

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 and Instruction	1	Declaration in Support of Establishing Parentage	Declaration in Support of Establishing Parentage 2019 Final 12112019.docx		Yes	Yes	Fillable Printable

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: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	147,798	1,998	145,800
Annual IC Time Burden (Hours)	28,082	6,212	21,870
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.