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Federal forms, ICRs, and supporting documents

Information Collection Request

APPLICATIONS AND DISCONTINUANCES FOR AID TO FAMILIES WITH DEPENDENT CHILDREN (AFDC) AND MEDICAID

ICR 198703-0970-007 · OMB 0970-0003 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
115746 APPLICATIONS AND DISCONTINUANCES FOR AID TO FAMILIES WITH DEPENDENT CHILDREN (AFDC) AND MEDICAID Form Migrated
ICR Details
0970-0003 198703-0970-007
Historical Active 198606-0960-012
HHS/ACF
APPLICATIONS AND DISCONTINUANCES FOR AID TO FAMILIES WITH DEPENDENT CHILDREN (AFDC) AND MEDICAID
Revision of a currently approved collection   No
Regular
Approved without change 03/24/1987
Retrieve Notice of Action (NOA) 03/24/1987
  Inventory as of this Action Requested Previously Approved
09/30/1988 09/30/1988
216 0 0
864 0 0
0 0 0
THE INFORMATION COLLECTED BY USE OF THE FORM SSA-3800 IS NEEDED AND USED TO MONITOR THE AID TO FAMILIES WITH DEPENDENT CHILDREN (AFDC) PROGRAM. THE AFFECTED PUBLIC IS COMPRISED OF STATE AGENCIES ADMINISTERING AND SUPERVISING THE ADMINISTRATION OF THE AFDC PROGRAM.
None
None
No
1
IC Title Form No. Form Name
APPLICATIONS AND DISCONTINUANCES FOR AID TO FAMILIES WITH DEPENDENT CHILDREN (AFDC) AND MEDICAID SSA-3800
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 216 0 0 0 216 0
Annual Time Burden (Hours) 864 0 0 0 864 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/24/1987