Information Collection

Ofa-100

IC 189465 under ICR 201208-0970-006 · OMB 0970-0366.

Documents and Forms

Document Name Document Type
Form 1 OFA-100 Form
1 OFA-100 OFA-100 form.doc Form
OFA-100 instructions.doc OFA-100 instructions IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	OFA-100	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	1	OFA-100	OFA-100 form.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: 6	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	Previously Approved
Annual Number of Responses for this IC	18	-447	465
Annual IC Time Burden (Hours)	432	-10,728	11,160
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
OFA-100 instructions	OFA-100 instructions.doc	08/27/2012

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