Information Collection

Pre-Expenditure Report Form

IC 10079 under ICR 202606-0970-008 · OMB 0970-0234.

Documents and Forms

Document Name Document Type
Form 1 SSBG Pre-Expenditure Reporting Form Pre-Expenditure Report Form Form
1 SSBG Pre-Expenditure Reporting Form SSBG Pre-Expenditure Report.xlsx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Pre-Expenditure Report Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 1397c (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	SSBG Pre-Expenditure Reporting Form	SSBG Pre-Expenditure Report.xlsx		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: 57	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	57	57
Annual IC Time Burden (Hours)	114	114
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.

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