Information Collection

Staff reports of program service receipt

IC 227922 under ICR 202003-0970-002 · OMB 0970-0506.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0506 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment G Staff Reports of Program Receipt_v9_Part 1_clean.DOC	Other-Staff reports
Attachment G Staff Reports of Program Receipt_v7_Part 2.pdf Attachment G Staff Reports of Program Receipt - Screen Shots	IC Document

IC Title:

Staff reports of program service receipt

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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
Other-Staff reports			Attachment G Staff Reports of Program Receipt_v9_Part 1_clean.DOC		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: 20

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	104,000	104,000
Annual IC Time Burden (Hours)	3,120	3,120
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment G Staff Reports of Program Receipt - Screen Shots	Attachment G Staff Reports of Program Receipt_v7_Part 2.pdf	04/05/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.