Information Collection

Ocse-75

IC 178847 under ICR 201912-0970-004 · OMB 0970-0320.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0320 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OCSE-75 OCSE-75	Form and Instruction
OCSE-75 Annual Report OCSE-75 Form and Instructions_08.15.19.pdf	Form and Instruction

IC Title:

OCSE-75

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:

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	OCSE-75	Annual Report	OCSE-75 Form and Instructions_08.15.19.pdf		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: 60

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	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	60	0	-3	63
Annual IC Time Burden (Hours)	3,600	-189	-180	3,969
Annual IC Cost Burden (Dollars)	0	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.