CSBG Annual Report: Grantees

Community Services Block Grant (CSBG) Annual Report

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0492 can be found here:

Documents and Forms

Document Name Document Type
Form 1 CSBG Annual Report: Grantees Form and Instruction
1 CSBG Module 1 CSBG Module 1 Revision Summary FY2019 _IOAS updates.docx Form and Instruction
2 CSBG Module 2 RPT_CSBG_AR OMB CLEAR MOD2 FR1 Clean_FY2019.xlsm Form and Instruction
3 CSBG Module 3 RPT_CSBG_AR OMB CLEAR MOD3 FR1 Clean_FY2019.xlsm Form and Instruction
4 CSBG Module 4 RPT_CSBG_AR OMB CLEAR MOD4 FR1 Clean_FY2019.xlsx Form and Instruction

Information Collection (IC) Details

IC Title:	CSBG Annual Report: Grantees	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	CSBG Module 1	CSBG Module 1 Revision Summary FY2019 _IOAS updates.docx	Yes	Yes	Fillable Fileable
Form and Instruction	2	CSBG Module 2	RPT_CSBG_AR OMB CLEAR MOD2 FR1 Clean_FY2019.xlsm	Yes	Yes	Fillable Fileable
Form and Instruction	3	CSBG Module 3	RPT_CSBG_AR OMB CLEAR MOD3 FR1 Clean_FY2019.xlsm	Yes	Yes	Fillable Fileable
Form and Instruction	4	CSBG Module 4	RPT_CSBG_AR OMB CLEAR MOD4 FR1 Clean_FY2019.xlsx	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: 52	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 52 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	52	0	0	52
Annual IC Time Burden (Hours)	10,296	0	-260	10,556
Annual IC Cost Burden (Dollars)	0	-269,706	0	269,706

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.