Information Collection

Statement Of Household Expenses And Contributions

IC 115588 under ICR 199202-0960-004 · OMB 0960-0456.

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Information Collection (IC) Details

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IC Title:	STATEMENT OF HOUSEHOLD EXPENSES AND CONTRIBUTIONS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 872,875	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	872,875	334,475	538,400
Annual IC Time Burden (Hours)	218,219	83,619	134,600
Annual IC Cost Burden (Dollars)	0	0	0

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