Information Collection

State Coordinator ATCS

IC 236438 under ICR 202002-1121-001 · OMB 1121-0372.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0372 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
State Coordinator ATCS	Form and Instruction
State Coordinators ATCS 2020 Statewide_Coordinators_Survey.docx	Form and Instruction

IC Title:

State Coordinator ATCS

Agency IC Tracking Number:

BJA

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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	none	State Coordinators ATCS	2020 Statewide_Coordinators_Survey.docx	TBD	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: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	54	54
Annual IC Time Burden (Hours)	18	18
Annual IC Cost Burden (Dollars)	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.