Information Collection

e-NMSN: State Profile

IC 250394 under ICR 202411-0970-010 · OMB 0970-0370.

Documents and Forms

Document Name Document Type
Form 1 e-NMSN: State Profile Form and Instruction
1 e-NMSN: State Profile 0970_0370_e-NMSN_State_Profile.docx Form and Instruction
1 e-NMSN: State Profile 0970_0370_e-NMSN_State_Profile.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	e-NMSN: State Profile	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	e-NMSN: State Profile	0970_0370_e-NMSN_State_Profile.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: 4	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	4	-1	5
Annual IC Time Burden (Hours)	1	0	1
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.