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Project Impact Survey
ANA Project Impact Assessment Survey
OMB: 0970-0379
IC ID: 192493
OMB.report
HHS/ACF
OMB 0970-0379
ICR 201004-0970-002
IC 192493
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0379 can be found here:
2025-01-13 - Revision of a currently approved collection
2022-03-30 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Project Impact Survey
Form
1 ACF-ANA-Project-Impact-Assessment SF-PPR
ACF-ANA-Project-Impact-Assessment SF-PPR.doc
Form
Project Impact Assessment Survey Notification Letter.doc
Project Impact Assessment Survey Notification Letter
IC Document
Chapter 2 - Project Impact Assessment Survey Manual.doc
Chapter 2 - Project Impact Assessment Survey Manual
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Project Impact Survey
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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
1
ACF-ANA-Project-Impact-Assessment SF-PPR
ACF-ANA-Project-Impact-Assessment SF-PPR.doc
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Community and Regional Development
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
85
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 New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
85
0
85
0
0
0
Annual IC Time Burden (Hours)
510
0
510
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Project Impact Assessment Survey Notification Letter
Project Impact Assessment Survey Notification Letter.doc
03/30/2010
Chapter 2 - Project Impact Assessment Survey Manual
Chapter 2 - Project Impact Assessment Survey Manual.doc
03/30/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.