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Repatriation State Contact List
U.S. Repatriation Program Forms
OMB: 0970-0474
IC ID: 263516
OMB.report
HHS/ACF
OMB 0970-0474
ICR 202502-0970-024
IC 263516
( )
Documents and Forms
Document Name
Document Type
Repatriation State Contact List.docx
Other-Contact List
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Repatriation State Contact List
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
Other-Contact List
Repatriation State Contact List.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
OHSEPR Repatriation and Disaster Human Services Case Management Records
FR Citation:
88 FR 63109
Number of Respondents:
220
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
440
0
0
0
0
440
Annual IC Time Burden (Hours)
110
0
0
0
0
110
Annual IC Cost Burden (Dollars)
0
0
0
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.
