Information Collection

Tracking the $25 Fee

IC 178500 under ICR 200701-0970-003 · OMB 0970-0017.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0017 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Tracking the $25 Fee	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 302.a

Information Collection Instruments:

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

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	216	216
Annual IC Time Burden (Hours)	216	216
Annual IC Cost Burden (Dollars)	26,352	26,352

Documents for IC

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