Intended Use Plan

Social Services Block Grant (SSBG) Post-Expenditure Report, Pre-Expenditure and Intended Use Plan

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0234 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Intended Use Plan Form
1 SSBG Post-Expenditure Reporting Form SSBG IUP Instructions_CC Final Draft.docx Form
1 SSBG Post-Expenditure Reporting Form SSBG IUP Instructions_CC Final Draft.docx Form
1 Intended Use Plan SSBG IUP Form V3.pdf Form
1 Intended Use Plan SSBG IUP Form V3.pdf Form

Information Collection (IC) Details

IC Title:	Intended Use Plan	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 96.74

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	SSBG Post-Expenditure Reporting Form	SSBG IUP Instructions_CC Final Draft.docx		Yes	Yes	Fillable Fileable
Form	1	Intended Use Plan	SSBG IUP Form V3.pdf		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: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	2,240	2,240
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.