Information Collection

CCWIS Self-Assessment – Administration

IC 245132 under ICR 202012-0970-017 · OMB 0970-0568.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0568 can be found here:

Documents and Forms

Document Name Document Type
CCWIS Administration Self-Assessment Tool v1.0.docx Other-Self-Assessment Tool
CCWIS Administration Self-Assessment Tool v1.0.docx Other-Self-Assessment Tool

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CCWIS Self-Assessment – Administration	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Self-Assessment Tool			CCWIS Administration Self-Assessment Tool v1.0.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: 55	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	55	55
Annual IC Time Burden (Hours)	550	550
Annual IC Cost Burden (Dollars)	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.