Information Collection

Tribal Organizational Assessessment Community Provider Interview

IC 220271 under ICR 201602-0970-011 · OMB 0970-0484.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0484 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Tribal Organizational Assessessment Community Provider Interview Form and Instruction
1 Tribal Organizational Assessment Community Provider Inte Tribal Organizational Assessment Community Provider Interview_revised.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Tribal Organizational Assessessment Community Provider Interview	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
Form and Instruction	1	Tribal Organizational Assessment Community Provider Interview	Tribal Organizational Assessment Community Provider Interview_revised.doc		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: 16	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	16	16
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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