Information Collection

State Improper Payments Report

IC 181818 under ICR 201007-0970-004 · OMB 0970-0323.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0323 can be found here:

Documents and Forms

Document Name Document Type
Form 1 State Improper Payments Report Form and Instruction
1 Improper Authorizations for Payment Data Collection Inst DCI 4-12-2010 (v24).doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State Improper Payments Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 98

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Improper Authorizations for Payment Data Collection Instructions	DCI 4-12-2010 (v24).doc		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 17	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 98 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	17	0	17
Annual IC Time Burden (Hours)	10,863	-1	10,864
Annual IC Cost Burden (Dollars)	0	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.