Information Collection

Ocse-100

IC 9796 under ICR 202003-0970-014 · OMB 0970-0017.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0017 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OCSE-100 State Plan Cover Page OCSE-100	Form and Instruction
OCSE-100 State Plan Cover Page OCSE-100 State Plan Cover Page with PRA_final for OMB v2.docx	Form and Instruction

IC Title:

OCSE-100

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-100				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
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	648	378	270
Annual IC Time Burden (Hours)	324	189	135
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.

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