View Information Collection (IC)

View Information Collection (IC)

IC Title:	ACF Optional-Use Data Sharing Request Form	Agency IC Tracking Number:	OPRE

IC Status: Unchanged

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-			ACF Optional-Use Data Sharing Request Form - PRA Review - Updated.docx		Yes	Yes	Fillable Fileable

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: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	100	0	0	0	0	100
Annual IC Time Burden (Hours)	300	0	0	0	0	300
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
SSA - ACF Optional-Use Data Sharing Request Form	SSA - Formative for ACF Program Support - GenIC - Data Sharing Request Template_fnl clean.docx	05/15/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.