SPECIAL MAIL SURVEYS OF SPONSORS OF WIN PROGRAMS

ICR 198007-0980-002

OMB: 0980-0002

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
116038 Migrated
ICR Details
0980-0002 198007-0980-002
Historical Active 198012-1205-008
HHS/HDSO
SPECIAL MAIL SURVEYS OF SPONSORS OF WIN PROGRAMS
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 09/08/1980
Retrieve Notice of Action (NOA) 07/24/1980
  Inventory as of this Action Requested Previously Approved
02/28/1981 02/28/1981
1,040 0 0
390 0 0
0 0 0

THE PROJECT WILL OBTAIN PROGRAM AND CLIENT INFORMATION ON TWO COMPONENTS OF THE WORK INCENTIVE (WIN) PROGRAM: INTENSIVE EMPLOYABILITY SERVICES AND CHILD CARE. DATA WILL BE GATHERED BY MAIL SURVEYS OF WIN STAFF AND WILL BE USED TO IMPROVE THE SERVICES FOR WELFARE RECIPIENTS ENROLLED IN WIN.

None
None


No

1
IC Title Form No. Form Name
SPECIAL MAIL SURVEYS OF SPONSORS OF WIN PROGRAMS MT-1069A

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,040 0 0 0 1,040 0
Annual Time Burden (Hours) 390 0 0 0 390 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/24/1980


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