Enhanced Services for the Hard-to-Employ Demonstration and Evaluation: Philadelphia 36-Month Follow-Up Data Collection

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
OMB HtE PA 36M_Phone Intro Script_2-4-08.doc	Supplementary Document	Uploaded 2008-02-22	Repair queued
OMB HtE PA 36M_In-Person Intro Script_2-4-08.doc	Supplementary Document	Uploaded 2008-02-22	Repair queued
2-14-08 memo.pdf	Supplementary Document	Uploaded 2008-02-22	Available
OMB HtE PA 36M_Supporting Statement Part B REV_11-05-07.doc	Supporting Statement B	Uploaded 2007-11-16	Available
OMB HtE PA 36M_App E_Refs_9-26-07.doc	Supplementary Document	Uploaded 2007-11-16	Available
OMB HtE PA 36M_App D_Authorities.doc	Supplementary Document	Uploaded 2007-11-16	Available
HTE Philadelphia 36-Month Abstract.doc	Supplementary Document	Uploaded 2007-09-06	Available
OMB HtE PA 36M_Supporting Statement Part A REV_02-08-08.doc	Supporting Statement A	Uploaded 2008-02-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
182931	Enhanced Services for the Hard-to-Employ Demonstration and Evaluation: Philadelphia 36-Month Follow Up Data Collection	Other-Instrument	New

ICR Details

OMB Control No: 0970-0336	ICR Reference No: 200712-0970-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Enhanced Services for the Hard-to-Employ Demonstration and Evaluation: Philadelphia 36-Month Follow-Up Data Collection
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/25/2008
	Date Received in OIRA: 12/06/2007
Terms of Clearance: This ICR is approved consistent with revised supporting statement and 2-14-08 memo. Per 2-14-08 memo, the costs to the federal government has been incorrectly reported. Within 6 months of approval for this collection, ACF shall submit a change request to correct this.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2011	36 Months From Approved
Responses	1,555	0	0
Time Burden (Hours)	1,166	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: See attached document.

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Authorizing Statute(s): PL: Pub.L. 42 - 613 1110 Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 33762	06/19/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 46634	08/27/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Enhanced Services for the Hard-to-Employ Demonstration and Evaluation: Philadelphia 36-Month Follow Up Data Collection

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ICR Summary of Burden

table that charts list of burden

	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	1,555	0	0	1,555	0	0
Annual Time Burden (Hours)	1,166	0	0	1,166	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The 36-month follow-up is a new data collection.

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Annual Cost to Federal Government: $2,007

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/06/2007

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