Information Collection

Your Town Focus Groups

IC 200666 under ICR 201112-3135-002 · OMB 3135-0130.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

Your Town Focus Groups

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.