Information Collection

Private Sector

IC 186490 under ICR 201111-0970-009 · OMB 0970-0353.

Documents and Forms

Document Name Document Type
Form 0 Private Sector Form
RPG Data Dictionary.pdf Other-data dictionary
0 survey Data Plan Sample.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Private Sector	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form	0	survey	Data Plan Sample.pdf		Yes	Yes	Fillable Printable
Other-data dictionary			RPG Data Dictionary.pdf		No	No	Paper Only

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: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	34	-10	44
Annual IC Time Burden (Hours)	5,967	-1,755	7,722
Annual IC Cost Burden (Dollars)	58,242	-17,130	75,372

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.