ANA Grantee Conference

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Document Name Document Type
Form 1 ANA Grantee Conference Form and Instruction
1 Conference Evaluation Conference_Eval.pdf Form and Instruction
1 Workshop Evaluation Workshop_Eval.pdf Form and Instruction
fast-track-PRA-submission-short-form ANA-2.doc Justification IC Document

Information Collection (IC) Details

IC Title:	ANA Grantee Conference	Agency IC Tracking Number:	ANA

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	Conference Evaluation	Conference_Eval.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	1	Workshop Evaluation	Workshop_Eval.pdf		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	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 Agency Discretion
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification	fast-track-PRA-submission-short-form ANA-2.doc	06/05/2014

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