Information Collection

CSBG Annual Report 2.1 (States)

IC 224194 under ICR 202607-0970-012 · OMB 0970-0492.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2.1 CSBG Annual Report - FY25 CSBG Annual Report 2.1 (States)	Form and Instruction
2.1 CSBG Annual Report - FY25 RPT_CSBG Annual Report 2.1_Feb 2025 Updated.docx	Form and Instruction
Module 3 SmartForm - 2026.xlsm Module 3 - Redesigned 2026	IC Document

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:

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
Form and Instruction	2.1				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: 56

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	Previously Approved
Annual Number of Responses for this IC	19	19
Annual IC Time Burden (Hours)	3,696	3,696
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Module 3 - Redesigned 2026		07/29/2026

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

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