Electronic Transmission Financial Data Match Result File

Financial Institution Data Match / Federally Assisted State Transmitted Levy

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0196 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Electronic Transmission Financial Data Match Result File Form and Instruction
1 MSFIDM Record Specs. 0970-0196_MSFIDM_Record Specs.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Electronic Transmission Financial Data Match Result File	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 92

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	MSFIDM Record Specs.	0970-0196_MSFIDM_Record Specs.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 183	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	183	-21	204
Annual IC Time Burden (Hours)	0	0	0
Annual IC Cost Burden (Dollars)	292,068	226,951	65,117

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.