Ocse-21-u4

State Plan for Child Support Collection and Establishment of Paternity Under Title IV-D of the Social Security Act

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0017 can be found here:

Documents and Forms

Document Name Document Type
Form OCSE-21-U4 OCSE-21-U4 Form and Instruction
OCSE-21-U4 Tranmittal Attachment III OCSE 21-U4 Transmittal Form.doc Form and Instruction

Information Collection (IC) Details

IC Title:	OCSE-21-U4	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 302.a

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OCSE-21-U4	Tranmittal	Attachment III OCSE 21-U4 Transmittal Form.doc		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	270	0	54	216
Annual IC Time Burden (Hours)	68	14	0	54
Annual IC Cost Burden (Dollars)	0	0	0	0

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.