Information Collection

Adoptive Family Relief Act Refund Application

IC 221041 under ICR 202604-1405-003 · OMB 1405-0223.

Documents and Forms

Document Name Document Type
Form DS-7781 Adoptive Family Relief Act Refund Application Adoptive Family Relief Act Refund Application Form
Form DS-7781 Adoptive Family Relief Act Refund Application Adoptive Family Relief Act Refund Application Form
DS-7781 Adoptive Family Relief Act Refund Application DS-7781.pdf Form
DS-7781 Adoptive Family Relief Act Refund Application DS-7781.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Adoptive Family Relief Act Refund Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	DS-7781	Adoptive Family Relief Act Refund Application	DS-7781.pdf		Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	94	94

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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].