Title VI Part C Grant Application

Application for Older Americans Act, Title VI Parts A/B and C Grants

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0064 can be found here:

Documents and Forms

Document Name Document Type
Title VI Part C Grant Application Form and Instruction
Title VI Part C Grant Application 0985-New Title VI 2020-2023 App MS.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Title VI Part C Grant Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 1326.19

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Title VI Part C Grant Application	0985-New Title VI 2020-2023 App MS.pdf		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: 250	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	125	125
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.