Information Collection

Client Case Closure

IC 237961 under ICR 202511-0970-005 · OMB 0970-0467.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3 Client Case Closure	Form
Form 3 Client Case Closure Client Case Closure	Form
FY25 TVAP Reporting Reference Guide - clean.docx	Instruction
FY25 TVAP Reporting Reference Guide - clean.docx	Instruction
3 Client Case Closure FY25 TVAP Performance Indicators_clean.docx	Form
3 Client Case Closure FY25 TVAP Performance Indicators_clean.docx	Form

IC Title:

Client Case Closure

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	3				Yes	Yes	Fillable Fileable
Instruction					Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,300

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,765	-433	2,198
Annual IC Time Burden (Hours)	295	-72	367
Annual IC Cost Burden (Dollars)	0	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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