Information Collection

Annual Performance Report for the State Grant for Assistive Technology Program

IC 245267 under ICR 202012-0985-001 · OMB 0985-0042.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0042 can be found here:

Documents and Forms

Document Name Document Type
Annual Performance Report for the State Grant for Assistive Technology Program Form and Instruction
Annual Performance Report for the State Grant for Assist 0042 State Grant for AT Annual Progress Report Reinstate w Change.docx Form and Instruction
Annual Performance Report for the State Grant for Assist 0042 State Grant for AT Annual Progress Report Reinstate w Change.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Annual Performance Report for the State Grant for Assistive Technology Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 and Instruction	NA	Annual Performance Report for the State Grant for Assistive Technology Program	0042 State Grant for AT Annual Progress Report Reinstate w Change.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: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	22,624	22,624
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.