Information Collection

Office of Head Start Improper Payment Reviews

IC 262700 under ICR 202604-0970-003 · OMB 0970-0558.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0558 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Phase One transaction data collection instrument and Data Validation Tool (Scanner) Office of Head Start Improper Payment Reviews Form
Form 2 Phase Two Payment Management Reconciliation Instrument Office of Head Start Improper Payment Reviews Form
1 Phase One transaction data collection instrument and Dat OHS Improper Payment Review Phase 1 Transaction Worksheet.xlsx Form
2 Phase Two Payment Management Reconciliation Instrument OHS Improper Payment Review Phase 2 Sample Worksheet.xlsx Form
Submission Template for Monitoring Improper Payment Reviews_4.2.26_mj_ek.docx Monitoring GenIC Submission Form - OHS Improper Payment Reviews IC Document
Change Request - Improper Payment Reviews_4.2.26_mj_ek.docx Change Request - OHS Improper Payments IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Office of Head Start Improper Payment Reviews	Agency IC Tracking Number:	OHS

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Phase One transaction data collection instrument and Data Validation Tool (Scanner)	OHS Improper Payment Review Phase 1 Transaction Worksheet.xlsx		Yes	Yes	Fillable Fileable
Form	2	Phase Two Payment Management Reconciliation Instrument	OHS Improper Payment Review Phase 2 Sample Worksheet.xlsx		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: 300	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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	600	300	300
Annual IC Time Burden (Hours)	1,800	1,500	300
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Monitoring GenIC Submission Form - OHS Improper Payment Reviews	Submission Template for Monitoring Improper Payment Reviews_4.2.26_mj_ek.docx	04/06/2026
Change Request - OHS Improper Payments	Change Request - Improper Payment Reviews_4.2.26_mj_ek.docx	04/06/2026

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

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