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OMB Control No: 1076-0017	ICR Reference No: 199005-1076-002
Status: Historical Active	Previous ICR Reference No: 198809-1076-002
Agency/Subagency: DOI/BIA	Agency Tracking No:
Title: (25 CFR PART 20), FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAM
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/08/1990
	Date Received in OIRA: 05/30/1990
Terms of Clearance: In accordance with the Paperwork Reduction Act and 5 CFR 1320, this information collection is approved for use through March 31, 1992. Before the BIA resubmits this information collection to OMB for review the BIA should take appropriate steps to remove any duplication of dat collected on these forms with other data the BIA already collects or duplication among the forms themselves. To remove unnecessary duplication and to further minimize the burden of this collection on respondents, BIA should consider consolidating forms BIA #5-6601 and BIA #5-6603. As an alternative the Bureau should also consider developing two separate forms, one to be used by individuals applying for financial assistance and social service, and one for individuals applying only for social services. The current system of requiring individuals seeking financial assistance to fill out both of the aforementioned forms is inappropriate since many of the elements on th two forms are duplicative.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/1992	03/31/1992
Responses	230,875	0	0
Time Burden (Hours)	206,125	0	0
Cost Burden (Dollars)	0	0	0

Abstract: THESE FORMS REQUEST FINANCIAL, DEMOGRAPHIC AND EMPLOYMENT INFORMATION ON CLIENTELE FOR THE PURPOSE OF DETERMINING ELIGIBILITY TO RECEIVE FINANCIAL ASSISTANCE. THESE FORMS ALLOW THE BUREAU SOCIAL WORKER TO DETERMINE THE DEGREE OF UNMET NEED AND ARRANGE FOR A MONTHLY PAYMENT.

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
(25 CFR PART 20), FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAM	5-6601, 5-6603, 5-6604, 506605

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	230,875	230,875
Annual Time Burden (Hours)	206,125	206,125
Annual Cost Burden (Dollars)	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:

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

View ICR - OIRA Conclusion