OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

QUARTERLY REPORT OF RECOVERIES OF OVERPAYMENTS, AID TO FAMILIES WITH DEPENDENT CHILDREN

ICR 199501-0970-001 · OMB 0970-0038 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
115853 QUARTERLY REPORT OF RECOVERIES OF OVERPAYMENTS, AID TO FAMILIES WITH DEPENDENT CHILDREN Form Migrated
ICR Details
0970-0038 199501-0970-001
Historical Active 198708-0970-005
HHS/ACF
QUARTERLY REPORT OF RECOVERIES OF OVERPAYMENTS, AID TO FAMILIES WITH DEPENDENT CHILDREN
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 04/06/1995
Retrieve Notice of Action (NOA) 01/10/1995
This collection is approved through 4/96 provided that HHS agrees to do the following: (1) add the OMB number and expiration date to the form; (2) add the burden statement to the instructions; (3) add more instructions on the purpose and requirements under "Status of Accounts Receivable"; (4) add to the definitions/ instructions page instructions to complete the boxes regarding the "Recipient Organization", the "Period Covered by this Report" and the certification section at the bottom of the form; and (5) provide further specification under 3a of the instructions that former recipients must now be counted and provide an example to clarify a case where a collection may be made through reduced assistance payments for an individual who is a former recipient. In addition, consult with a number of States regarding the burden hours estimated to complete the revised form as well as the State's ability to collect the new information requested. HHS will report this information to OMB as part of the Supporting Statement in the Department's next submission to OMB. The burden hours have been approved at the previously approved level rather than at the reduced level originally requested by the Department because new information has been added to the form and it is not entirely clear that States have developed automated procedures to collect this information, particularly given the new data elements required. The estimated burden hours should be reevaluated after consulting further with the States.
  Inventory as of this Action Requested Previously Approved
04/30/1996 04/30/1996
204 0 0
10,800 0 0
0 0 0
THE INFORMATION COLLECTED BY THE USE OF THE FORM WILL BE USED TO ASSESS THE EFFECTIVENESS OF THE STATE'S RECOVERY EFFORTS OF OUTSTANDING OVERPAYMENT BENEFITS WHICH WERE MADE IN ERROR TO CLIENTS. THE INFORMATION WILL FACILITATE ACF'S ABILITY TO TRACK RECOVERIES BY STATE AGENCIES AND WILL ALLOW COMPARISONS OF THE EFFECTIVENESS OF EACH STATE COMPARED TO THE OVERALL.
None
None
No
1
IC Title Form No. Form Name
QUARTERLY REPORT OF RECOVERIES OF OVERPAYMENTS, AID TO FAMILIES WITH DEPENDENT CHILDREN ACF-4972
  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 204 0 0 204 0 0
Annual Time Burden (Hours) 10,800 0 0 10,800 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
01/10/1995