Information Collection

NEW Plan Guidance for non-477 Tribes

IC 9972 under ICR 201602-0970-005 · OMB 0970-0174.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0174 can be found here:

Documents and Forms

Document Name Document Type
NEW plan guidance non-477.2016-2019.docx Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NEW Plan Guidance for non-477 Tribes	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 287.287.7 45 CFR 287.70

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			NEW plan guidance non-477.2016-2019.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Previously Approved
Annual Number of Responses for this IC	16	16
Annual IC Time Burden (Hours)	464	464
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.