Information Collection

Instrument 3 - Performance Reporting Data Entry Form

IC 236138 under ICR 202008-0970-007 · OMB 0970-0536.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0536 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Instrument 3 - Performance Reporting Data Entry Form Form and Instruction
1 SRAE Performance Reporting System Data Entry Form Instrument 3_SRAE Performance Reporting System Data Entry Form_ rev 8-7_ForOMB_Clean.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Instrument 3 - Performance Reporting Data Entry Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	SRAE Performance Reporting System Data Entry Form	Instrument 3_SRAE Performance Reporting System Data Entry Form_ rev 8-7_ForOMB_Clean.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: 137	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	274	0	274
Annual IC Time Burden (Hours)	4,658	274	4,384
Annual IC Cost Burden (Dollars)	0	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.