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State Performance Report for FY 2022-2025
State Performance Report for FY 2022-2025
OMB: 0985-0072
IC ID: 247578
OMB.report
HHS/ACL
OMB 0985-0072
ICR 202105-0985-002
IC 247578
( )
Documents and Forms
Document Name
Document Type
State Performance Report for FY 2022-2025
Form and Instruction
State Performance Report
New State_Performance_Report_Requirements 0521.pdf
Form and Instruction
State Performance Report
New State_Performance_Report_Requirements 0521.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
State Performance Report for FY 2022-2025
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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 and Instruction
NA
State Performance Report
New State_Performance_Report_Requirements 0521.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
56
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
56
0
56
0
0
0
Annual IC Time Burden (Hours)
1,876
0
1,876
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.