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ACF-403 Record Review Worksheet: case record reviews (IC-2 - ACF-403)
Child Care Improper Payments Data Collection Instructions
OMB: 0970-0323
IC ID: 273857
OMB.report
HHS/ACF
OMB 0970-0323
ICR 202501-0970-010
IC 273857
( )
Documents and Forms
Document Name
Document Type
Form ACF-403
ACF-403 Record Review Worksheet: case record reviews (IC-2 - ACF-403)
Form and Instruction
ACF-403 Improper Payment DCI - ACF-403 Record Review Worksheet:
IC-2 [ACF-403].pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
ACF-403 Record Review Worksheet: case record reviews (IC-2 - ACF-403)
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 98
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
ACF-403
Improper Payment DCI - ACF-403 Record Review Worksheet: case record reviews
IC-2 [ACF-403].pdf
Yes
Yes
Fillable Printable
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:
52
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
4,784
0
4,784
0
0
0
Annual IC Time Burden (Hours)
14,352
0
14,352
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.