Information Collection

State Performance Report for FY 2022-2025

IC 247578 under ICR 202105-0985-002 · OMB 0985-0072.

Documents and Forms

Document Name Document Type
State Performance Report for FY 2022-2025 Form and Instruction
State Performance Report New State_Performance_Report_Requirements 0521.pdf Form and Instruction
State Performance Report New State_Performance_Report_Requirements 0521.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State Performance Report for FY 2022-2025	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	State Performance Report	New State_Performance_Report_Requirements 0521.pdf		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)	1,876	1,876
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.