Your Town Focus Groups

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3135-0130 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Your Town Focus Groups Form and Instruction
1 Interview protocol YT protocol 5 participants rev 2.docx Form and Instruction
NEA-YT Focus Group Consent Form.doc Your Town Focus Group Consent Form IC Document
Generic Clearance Submission Template.docx Generic Clearance Submission Template IC Document

Information Collection (IC) Details

IC Title:	Your Town Focus Groups	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Interview protocol	YT protocol 5 participants rev 2.docx		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: 30	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Your Town Focus Group Consent Form	NEA-YT Focus Group Consent Form.doc	01/03/2012
Generic Clearance Submission Template	Generic Clearance Submission Template.docx	01/03/2012

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