Information Collection

NH States

IC 179587 under ICR 200704-0970-004 · OMB 0970-0166.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0166 can be found here:

Documents and Forms

Document Name Document Type
02 NDNH Output Record Specs 8-30-06.doc Other-output tape format
02 NDNH Input Record Specs 8-30-06.doc Other-Input tape format

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NH States	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-output tape format			02 NDNH Output Record Specs 8-30-06.doc		No	No	Fillable Fileable
Other-Input tape format			02 NDNH Input Record Specs 8-30-06.doc		No	No	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: Location and Collection System	FR Citation: 70 FR 21200

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

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	4,500	4,500
Annual IC Time Burden (Hours)	300,150	300,150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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