Information Collection

State child welfare records: data file submission

IC 234183 under ICR 202109-0970-018 · OMB 0970-0402.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0402 can be found here:

Documents and Forms

Document Name Document Type
SSA Attachment 12 MIHOPE-K Child Welfare Records Request_unchanged.docx Other-Data File Submission
SSA Attachment 12 MIHOPE-K Child Welfare Records Request_unchanged.docx Other-Data File Submission

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State child welfare records: data file submission	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
Other-Data File Submission			SSA Attachment 12 MIHOPE-K Child Welfare Records Request_unchanged.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: 11	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	22	14	8
Annual IC Time Burden (Hours)	330	210	120
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.