Information Collection

Title VI Parts A/B and C Grant Application

IC 237031 under ICR 202206-0985-001 · OMB 0985-0064.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Title VI Parts A/B and C Grant Application	Form and Instruction
Application for OAA Title VI Parts A/B and C 0064f FY2023 Application JA20220829-508.pdf	Form and Instruction
Application for OAA Title VI Parts A/B and C 0064f FY2023 Application JA20220829-508.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 1326.19

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Application for OAA Title VI Parts A/B and C	0064f FY2023 Application JA20220829-508.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: 545

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	545	250	295
Annual IC Time Burden (Hours)	395	125	270
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.