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Information Collection

Self-Sufficiency Matrix

IC 264800 under ICR 202602-0970-016 · OMB 0970-0628.

Documents and Forms
Document Name
Document Type
Other-Questionnaire
Information Collection (IC) Details

View Information Collection (IC)

Self-Sufficiency Matrix
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Questionnaire Instrument 1 - Self Sufficiency Matrix.pdf Yes Yes Fillable Fileable

Community and Social Services Social Services

 

680 0
   
Individuals or Households
 
   100 %

  Approved 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 680 0 0 0 0 680
Annual IC Time Burden (Hours) 1,020 0 0 0 0 1,020
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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