Information Collection

Head Start Family Voices Pilot Study

IC 205972 under ICR 201305-0970-004 · OMB 0970-0355.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0355 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
A1a. Program Recruitment Script.docx	Other-Script
A1b. Program Recruitment Screener.docx	Other-Screener
A2. Participant Recruitment Form.docx	Other-Recruitment Form
A3. Parent Qualitative Interview Protocol - All Modules.docx	Other-Protocol
A6. Staff Questionnaire.docx	Other-Questionnaire
A5. Parent Questionnaire.docx	Other-Questionnare
A4. Staff Qualitative Interview Protocol - All Modules.docx	Other-Protocol
HSFV Supporting Statement A 2-26-13 FINAL.docx HSFV Supporting Statement A 2-26-13 FINAL	IC Document
HSFV Supporting Statement B 2-26-13 FINAL.docx HSFV Supporting Statement B 2-26-13 FINAL	IC Document
Attachments-FINAL.docx Attachments-FINAL	IC Document
B1-B2-B3-C1-combined.docx B1-B2-B3-C1-combined	IC Document

IC Title:

Head Start Family Voices Pilot Study

Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire	A6. Staff Questionnaire.docx	Yes	Yes	Fillable Fileable
Other-Questionnare	A5. Parent Questionnaire.docx	Yes	Yes	Fillable Fileable
Other-Protocol	A4. Staff Qualitative Interview Protocol - All Modules.docx	Yes	Yes	Fillable Fileable
Other-Script	A1a. Program Recruitment Script.docx	Yes	Yes	Fillable Fileable
Other-Screener	A1b. Program Recruitment Screener.docx	Yes	Yes	Fillable Fileable
Other-Recruitment Form	A2. Participant Recruitment Form.docx	Yes	Yes	Fillable Fileable
Other-Protocol	A3. Parent Qualitative Interview Protocol - All Modules.docx	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 380

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	380	380
Annual IC Time Burden (Hours)	341	341
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
HSFV Supporting Statement A 2-26-13 FINAL	HSFV Supporting Statement A 2-26-13 FINAL.docx	02/26/2013
HSFV Supporting Statement B 2-26-13 FINAL	HSFV Supporting Statement B 2-26-13 FINAL.docx	02/26/2013
Attachments-FINAL	Attachments-FINAL.docx	02/26/2013
B1-B2-B3-C1-combined	B1-B2-B3-C1-combined.docx	02/26/2013

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