Information Collection

Semi-Annual Progress Report for Technical Assistance Program

IC 179768 under ICR 202003-1122-003 · OMB 1122-0017.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1122-0017 can be found here:

Documents and Forms

Document Name Document Type
Form 1122-0017 Semi-Annual Progress Report for Technical Assistance Program Form
1122-0017 Semi-annual Progress Report for the Technical Assistance TAProviderFormGMSSample.pdf muskie.usm.maine.edu/vawamei/attachments/forms/TAProviderFormGMSSample.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Semi-Annual Progress Report for Technical Assistance Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1122-0017	Semi-annual Progress Report for the Technical Assistance Program	TAProviderFormGMSSample.pdf	http://muskie.usm.maine.edu/vawamei/attachments/forms/TAProviderFormGMSSample.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.