Information Collection

Work Verification Plan

IC 183724 under ICR 202312-0970-011 · OMB 0970-0338.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0338 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Work Verification Plan Form and Instruction
1 Work Verification Plan Guidance Work_Verification_Plan_Guidance_cleanFR2.docx Form and Instruction
1 Work Verification Plan Guidance Work_Verification_Plan_Guidance_cleanFR2.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Work Verification Plan	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 261.60 - 261.63

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Work Verification Plan Guidance	Work_Verification_Plan_Guidance_cleanFR2.docx		Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	54	54
Annual IC Time Burden (Hours)	34,560	34,560
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.