Record Review Worksheet

Child Care Improper Payments Data Collection Instructions

Documents and Forms

Document Name Document Type
Form 1 Record Review Worksheet Form and Instruction
1 Improper Payment DCI Attachment A_Improper Payments DCI Final draft 30-day FRN_Clean Copy.docx Form and Instruction
1 Improper Payment DCI Improper Payments DCI Final Draft Clean Copy_UPDATED 12-14-21.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Record Review Worksheet	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 98

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Improper Payment DCI	Improper Payments DCI Final Draft Clean Copy_UPDATED 12-14-21.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: 52	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	4,784	92	4,692
Annual IC Time Burden (Hours)	30,283	583	29,700
Annual IC Cost Burden (Dollars)	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.