Worksheet For Integrated Afdc, Adult, Food Stamps, And Medicaid Eligibility Quality Control Reviews

WORKSHEET FOR INTEGRATED AFDC, ADULT, FOOD STAMPS, AND MEDICAID ELIGIBILITY QUALITY CONTROL REVIEWS

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	WORKSHEET FOR INTEGRATED AFDC, ADULT, FOOD STAMPS, AND MEDICAID ELIGIBILITY QUALITY CONTROL REVIEWS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ACF 4340				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 59,500	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	59,500	-3,500	63,000
Annual IC Time Burden (Hours)	655,904	-38,583	694,487
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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