Information Collection

Annual Self-Assessment

IC 221995 under ICR 202511-0970-007 · OMB 0970-0307.

Documents and Forms

Document Name Document Type
Form 1 Annual Self-Assessment Form and Instruction
Form 1 State Court Improvement Program Annual Self-Assessment Report Annual Self-Assessment Form and Instruction
1 State Court Improvement Program Annual Self-Assessment R SCIP Self Assessment 0970–0307.docx Form and Instruction
1 State Court Improvement Program Annual Self-Assessment R SCIP Self Assessment 0970–0307.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Annual Self-Assessment	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	State Court Improvement Program Annual Self-Assessment Report	SCIP Self Assessment 0970â0307.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: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	53	53
Annual IC Time Burden (Hours)	2,120	2,120
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.

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