Information Collection

Child, Adolescent and Family Branch Technical Assistance Enterprise Feedback Survey

IC 203034 under ICR 201103-0930-003 · OMB 0930-0197.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0197 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Contractor Attachm Child, Adolescent and Family Branch Technical Assistance Enterprise Feedback Survey	Form and Instruction
Contractor Attachm Contractor Attachments Contractor Attachments, 6-8-12.docx	Form and Instruction
Contractor Surveys OMB Request, 6-11-12.doc Justification	IC Document
Trans.Let-4-2012.doc Letter	IC Document

IC Title:

Child, Adolescent and Family Branch Technical Assistance Enterprise Feedback Survey

Agency IC Tracking Number:

IC Status: New

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
Form and Instruction	Contractor Attachments	Contractor Attachments	Contractor Attachments, 6-8-12.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 626

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	626	626
Annual IC Time Burden (Hours)	104	104
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification	Contractor Surveys OMB Request, 6-11-12.doc	06/11/2012
Letter	Trans.Let-4-2012.doc	06/11/2012

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