Information Collection

Grievance or Response to Adverse Action

IC 233291 under ICR 202102-0575-007 · OMB 0575-0189.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0575-0189 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Grievance or Response to Adverse Action	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 3560

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	4,300	4,300
Annual IC Time Burden (Hours)	2,150	2,150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.