Information Collection

Detailed Case Data Component (Child File and Agency File) - Programmatic Staff

IC 260705 under ICR 202606-0970-004 · OMB 0970-0424.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Agency File Data Elements.docx	Other-Data Elements
Agency File Data Elements.docx	Other-Data Elements
Agency File Submission Instructions.docx	Instruction
Agency File Submission Instructions.docx	Instruction
Child File Data Elements.docx	Other-Data Elements
Child File Data Elements.docx	Other-Data Elements
Child File Submission Instructions.docx	Instruction
Child File Submission Instructions.docx	Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 1340

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Data Elements	Yes	Yes	Fillable Fileable
Instruction	Yes	Yes	Printable Only
Other-Data Elements	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: 52

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	52	52
Annual IC Time Burden (Hours)	3,401	3,401
Annual IC Cost Burden (Dollars)	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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