Staff Focus Group

Pregnancy Assistance Fund (PAF) Implementation Study

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0428 can be found here:

Documents and Forms

Document Name Document Type
0990-New_PAF Instrument 2_Master Protocol For Small Group Interviews.docx Other-Guide
0990-_New_PAF_Attachment C_ConsentAssent Forms.docx Consent Letters and Forms and Youth Assent Form for Focus groups IC Document

Information Collection (IC) Details

IC Title:	Staff Focus Group	Agency IC Tracking Number:

Is this a Common Form? No		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
Other-Guide			0990-New_PAF Instrument 2_Master Protocol For Small Group Interviews.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 13	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	13	13
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Consent Letters and Forms and Youth Assent Form for Focus groups	0990-_New_PAF_Attachment C_ConsentAssent Forms.docx	02/24/2015

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