TITLE VI PROGRAM PERFORMANCE REPORT Part C

Annual Performance Reporting of the Administration for Community Living’s American Indian, Alaskan Natives and Native Hawaiian Programs

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0059 can be found here:

Documents and Forms

Document Name Document Type
TITLE VI PROGRAM PERFORMANCE REPORT Part C Form and Instruction
Title VI PPR Part C 0059 Title VI PPR Revision 3.4.19.docx Form and Instruction

Information Collection (IC) Details

IC Title:	TITLE VI PROGRAM PERFORMANCE REPORT Part C	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Title VI PPR Part C	0059 Title VI PPR Revision 3.4.19.docx		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: 237	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-237	237
Annual IC Time Burden (Hours)	-393	393
Annual IC Cost Burden (Dollars)	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.