Information Collection

Child Support Agency Confidential Information Form

IC 222797 under ICR 202511-0970-004 · OMB 0970-0085.

Documents and Forms

Document Name Document Type
Form 1 Child Support Agency Confidential Information Form Form
Form 1 1 Child Support Agency Confidential Information Form Form
1 1 Child Support Agency Confidential Information Form (1).pdf Form
1 1 Child Support Agency Confidential Information Form (1).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Child Support Agency Confidential Information Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 303.7(a)(4)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	1	Child Support Agency Confidential Information Form (1).pdf		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: 54	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	921,186	-118,746	1,039,932
Annual IC Time Burden (Hours)	46,059	-5,938	51,997
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.

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