Supplemental Work Outcomes Report

TANF Work Outcomes Measures

Documents and Forms

Document Name Document Type
3A. Instructions - Supplemental Work Outcomes Report2.docx Instruction
3 Supplemental Work Outcomes Report 3B. Supplemental Work Outcomes Report.xlsx Form

Information Collection (IC) Details

IC Title:	Supplemental Work Outcomes Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Instruction			3A. Instructions - Supplemental Work Outcomes Report2.docx		Yes	Yes	Printable Only
Form	3	Supplemental Work Outcomes Report	3B. Supplemental Work Outcomes Report.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: Temporary Assistance for Needy Families (TANF) Data	FR Citation: 89 FR 25880

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

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	54	54
Annual IC Time Burden (Hours)	1,620	1,620
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.