QUARTERLY REPORT OF RECOVERIES OF OVERPAYMENTS, AID TO FAMILIES WITH DEPENDENT CHILDREN

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
115853	QUARTERLY REPORT OF RECOVERIES OF OVERPAYMENTS, AID TO FAMILIES WITH DEPENDENT CHILDREN Form	Migrated

ICR Details

OMB Control No: 0970-0038	ICR Reference No: 199501-0970-001
Status: Historical Active	Previous ICR Reference No: 198708-0970-005
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: QUARTERLY REPORT OF RECOVERIES OF OVERPAYMENTS, AID TO FAMILIES WITH DEPENDENT CHILDREN
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/06/1995
	Date Received in OIRA: 01/10/1995
Terms of Clearance: This collection is approved through 4/96 provided that HHS agrees to do the following: (1) add the OMB number and expiration date to the form; (2) add the burden statement to the instructions; (3) add more instructions on the purpose and requirements under "Status of Accounts Receivable"; (4) add to the definitions/ instructions page instructions to complete the boxes regarding the "Recipient Organization", the "Period Covered by this Report" and the certification section at the bottom of the form; and (5) provide further specification under 3a of the instructions that former recipients must now be counted and provide an example to clarify a case where a collection may be made through reduced assistance payments for an individual who is a former recipient. In addition, consult with a number of States regarding the burden hours estimated to complete the revised form as well as the State's ability to collect the new information requested. HHS will report this information to OMB as part of the Supporting Statement in the Department's next submission to OMB. The burden hours have been approved at the previously approved level rather than at the reduced level originally requested by the Department because new information has been added to the form and it is not entirely clear that States have developed automated procedures to collect this information, particularly given the new data elements required. The estimated burden hours should be reevaluated after consulting further with the States.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/1996	04/30/1996
Responses	204	0	0
Time Burden (Hours)	10,800	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: THE INFORMATION COLLECTED BY THE USE OF THE FORM WILL BE USED TO ASSESS THE EFFECTIVENESS OF THE STATE'S RECOVERY EFFORTS OF OUTSTANDING OVERPAYMENT BENEFITS WHICH WERE MADE IN ERROR TO CLIENTS. THE INFORMATION WILL FACILITATE ACF'S ABILITY TO TRACK RECOVERIES BY STATE AGENCIES AND WILL ALLOW COMPARISONS OF THE EFFECTIVENESS OF EACH STATE COMPARED TO THE OVERALL.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
QUARTERLY REPORT OF RECOVERIES OF OVERPAYMENTS, AID TO FAMILIES WITH DEPENDENT CHILDREN	ACF-4972

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	204	0	0	204	0	0
Annual Time Burden (Hours)	10,800	0	0	10,800	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/10/1995

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