Information Collection

Financial Status Report (Short Form)

IC 12586 under ICR 200704-1121-005 · OMB 1121-0264.

Documents and Forms

Document Name Document Type
Form SF269A Financial Status Report (Short Form) Form and Instruction
SF269A Financail Status Report CC OMB Working file sf269may2005 092005.wpd sf269.ojp.usdoj.gov/sf269/ Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Financial Status Report (Short Form)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SF269A	Financail Status Report	CC OMB Working file sf269may2005 092005.wpd	https://sf269.ojp.usdoj.gov/sf269/	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15,304	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Previously Approved
Annual Number of Responses for this IC	61,216	61,216
Annual IC Time Burden (Hours)	30,608	30,608
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.