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Federal forms, ICRs, and supporting documents

Information Collection Request

REPORT ON CLAIMS OF GOOD CAUSE FOR REFUSING TO COOPERATE IN ESTABLISHING PATERNITY AND SECURING CHILD SUPPORT AND CASE REPORT

ICR 198703-0970-076 · OMB 0970-0073 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
115936 REPORT ON CLAIMS OF GOOD CAUSE FOR REFUSING TO COOPERATE IN ESTABLISHING PATERNITY AND SECURING CHILD SUPPORT AND CASE REPORT Form Migrated
ICR Details
0970-0073 198703-0970-076
Historical Active 198510-0960-001
HHS/ACF
REPORT ON CLAIMS OF GOOD CAUSE FOR REFUSING TO COOPERATE IN ESTABLISHING PATERNITY AND SECURING CHILD SUPPORT AND CASE REPORT
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
10/31/1987 10/31/1987
10,076 0 0
2,525 0 0
0 0 0
THE DATA COLLECTED B THESE FORMS IS REQUIRED BY LAW AND WILL BE USED TO MONITOR THE PROPER ADMINISTRATION OF GOOD CAUSE CLIMS AND TO EVALUATE THE REASONS FOR THE EXISTENCE. THE DATA WILL BE USED BY CONGRESSIONAL COMMITTEES, DEPARTMENTS AND OFFICES OF HHS AS AN AID TO LEGISLATIVE AND ADMINISTRA TIVE DECISIONMAKING, AND BY CONTRACTORS EMPLOYED BY THE DEPARTMENT. I WILL ALSO BE USED TO ANSWER QUESTIONS FROM THE GENERAL PUBLIC.
None
None
No
1
IC Title Form No. Form Name
REPORT ON CLAIMS OF GOOD CAUSE FOR REFUSING TO COOPERATE IN ESTABLISHING PATERNITY AND SECURING CHILD SUPPORT AND CASE REPORT SSA-4680 &, SSA-4681-U4
  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 10,076 0 0 0 10,076 0
Annual Time Burden (Hours) 2,525 0 0 0 2,525 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