Information Collection

Quarterly Performance Report

IC 9812 under ICR 200705-0970-003 · OMB 0970-0036.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0036 can be found here:

Documents and Forms

Document Name Document Type
ORR-6 Form Connie's Revisions May 15 number 3 plus Annual Services Plan.doc Other-instrument

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Quarterly Performance Report	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-instrument			ORR-6 Form Connie's Revisions May 15 number 3 plus Annual Services Plan.doc		No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	150	146	4
Annual IC Time Burden (Hours)	581	-163	744
Annual IC Cost Burden (Dollars)	0	-27,000	27,000

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.