Information Collection

Focus Groups - Individual Respondents

IC 193961 under ICR 201010-0503-001 · OMB 0503-0018.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix 2 Focus Group Questions 9-23.doc	Other-Focus Group Questions
Appendix 3 Focus Group Participant Communications.doc Focus Group Advance Letter/Phone Script	IC Document
Appendix 9 Westat Confidentiality.doc Westar Assurance of Confidentiality	IC Document
Appendix 10 JL Confidentiality.doc Jackson Lewis Assurance of Confidentiality	IC Document
Modified Focus Group telephone script 10- 28-10.docx Modified Phone Script for Focus Groups	IC Document
Modified focus group letter 10-29-10.doc Modified Advance Letter Independent Assessment Focus Groups	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Focus Group Questions			Appendix 2 Focus Group Questions 9-23.doc		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 450

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	450	450
Annual IC Time Burden (Hours)	1,013	1,013
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Focus Group Advance Letter/Phone Script	Appendix 3 Focus Group Participant Communications.doc	09/24/2010
Westar Assurance of Confidentiality	Appendix 9 Westat Confidentiality.doc	09/24/2010
Jackson Lewis Assurance of Confidentiality	Appendix 10 JL Confidentiality.doc	09/24/2010
Modified Phone Script for Focus Groups	Modified Focus Group telephone script 10- 28-10.docx	10/28/2010
Modified Advance Letter Independent Assessment Focus Groups	Modified focus group letter 10-29-10.doc	10/28/2010

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.