Information Collection

PSB-CY Child Information

IC 248372 under ICR 202412-0704-009 · OMB 0704-0620.

Documents and Forms

Document Name Document Type
PSBCY IS Incident Intake.pdf Other-Database Screenshots
PSBCY IS Incident Intake Updated.pdf Other-Database Screenshots
dd3179_NCRT.pdf Other-Referral Tool
dd3179 (2).pdf Other-Referral Tool

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	PSB-CY Child Information	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-Database Screenshots			PSBCY IS Incident Intake Updated.pdf		Yes	Yes	Fillable Fileable Signable
Other-Referral Tool			dd3179 (2).pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,500	500	2,000
Annual IC Time Burden (Hours)	2,500	500	2,000
Annual IC Cost Burden (Dollars)	75,300	23,800	51,500

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.