Information Collection

1: Program Application and Enrollment - Program staff (1a: application form)

IC 246003 under ICR 202604-0970-010 · OMB 0970-0566.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
1a.nFORM_ApplicationForm.docx	Other-Application Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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
Other-Application Form					Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title: OPRE Research and Evaluation Project Records

FR Citation: 87 FR 57198

Number of Respondents: 327

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 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	45,017	-5,033	50,050
Annual IC Time Burden (Hours)	4,502	-503	5,005
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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