Information Collection

Medical-Legal Partnerships Semi-Annual Quantitative Report

IC 279712 under ICR 202611-0970-002 · OMB 0970-0490.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 MLP Semi-Annual Report Form Medical-Legal Partnerships Semi-Annual Quantitative Report	Form
1 MLP Semi-Annual Report Form MLP Semi-Annual Report Form - October 2026 (Clean).docx	Form
MLP Plus PPR 0970-0490 Submission Template_clean_October 2026.docx MLP+ Submission Template - October 2026	IC Document
NonSub Change Request - MLP PPR_October 2026.docx NonSub Change Request - October 2026	IC Document

IC Title:

Agency IC Tracking Number:

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	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: 8

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	16	0	16
Annual IC Time Burden (Hours)	144	16	128
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
MLP+ Submission Template - October 2026		11/03/2026
NonSub Change Request - October 2026		11/03/2026

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

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