Information Collection

Client Case Closure Form

IC 237961 under ICR 202108-0970-010 · OMB 0970-0467.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0467 can be found here:

Documents and Forms

Document Name Document Type
Form 3 Client Case Closure Form Form
3 Client Case Closure Form Attachment E - OTIP-0499 - TVAP Revision - Client Case Closure Form_10.01.19.pdf Form
3 Client Case Closure Form Attachment E - OTIP-0499 - TVAP Revision - Client Case Closure Form_10.01.19.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Client Case Closure Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	3	Client Case Closure Form	Attachment E - OTIP-0499 - TVAP Revision - Client Case Closure Form_10.01.19.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: 1,100	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	Previously Approved
Annual Number of Responses for this IC	1,100	1,100
Annual IC Time Burden (Hours)	184	184
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.