Information Collection

Detailed Case Data Component (Child File and Agency File)

IC 203542 under ICR 202006-0970-006 · OMB 0970-0424.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0424 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Detailed Case Data Component (Child File and Agency File)	Form and Instruction
1 Detailed Case Data Component (Child File and Agency File Detailed Case Data Component (Child File and Agency File).docx	Form and Instruction

IC Title:

Detailed Case Data Component (Child File and Agency File)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 1340

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	1	Detailed Case Data Component (Child File and Agency File)	Detailed Case Data Component (Child File and Agency File).docx		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: 52

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	52	0	52
Annual IC Time Burden (Hours)	5,512	-2,184	7,696
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.