Information Collection

Performance Report for State Independent Living Program

IC 184900 under ICR 202401-0985-001 · OMB 0985-0043.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ILS PPR Performance Report for State Independent Living Program	Form
0043 ILS PPR Instructions Final 2024.pdf	Instruction
0043 ILS PPR Instructions Clean ROCIS.docx	Instruction
ILS PPR 0043 ILS PPR Instrument 2024 SOGI.pdf	Form
ILS PPR 0043 ILS PPR Instrument_with SPD-15 passback 3 clean ROCIS.docx	Form

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: 34 CFR 365 34 CFR 366 34 CFR 364

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
Instruction					Yes	Yes	Fillable Fileable
Form	NA				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 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	1,960	1,960
Annual IC Cost Burden (Dollars)	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.

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