Financial Data Match Record Specifications Match File Upload/Download: Portal Users

Multistate Financial Institution Data Match and Federally Assisted State Transmitted Levy (MSFIDM/FAST Levy)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0196 can be found here:

Documents and Forms

Document Name Document Type
0970-0196_MSFIDM_Record_Specifications_092023.docx Other-MSFIDM Record Specifications
0970-0196_MSFIDM_Record_Specifications_092023.docx Other-MSFIDM Record Specifications

Information Collection (IC) Details

IC Title:	Financial Data Match Record Specifications Match File Upload/Download: Portal Users	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-MSFIDM Record Specifications			0970-0196_MSFIDM_Record_Specifications_092023.docx		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: 263	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,052	316	736
Annual IC Time Burden (Hours)	88	27	61
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.