Information Collection

Healthy Marriage and Responsible Fatherhood Grantee Data Collection Plan Template (BUILD)

IC 277161 under ICR 202611-0970-004 · OMB 0970-0531.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
BUILD_DataCollectionPlanTemplate_11202020_toOPRE_120220.docx	Other-template
HMRF Grantee DataCollectionPlan_OMB_SSA_12092020_REV_KP 121420_clean_final.docx SSA - Build GenIC Prog Supp	IC Document
NOA_BUILD Template_12.17.2020.pdf NOA - Build GenIC	IC Document

IC Title:

Agency IC Tracking Number:

OPRE

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-template					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: 113

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	113	113
Annual IC Time Burden (Hours)	678	678
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - Build GenIC Prog Supp		08/21/2025
NOA - Build GenIC		08/21/2025

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

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