Information Collection

Tribal Organizationall Assessment Community Member/Elder

IC 220272 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form 1 Tribal Organizationall Assessment Community Member/Elder	Form and Instruction
1 Tribal Organizational Assessment Community Member-Elder Tribal Organizational Assessment Community Member-Elder Interview_revised.doc	Form and Instruction

IC Title:

Tribal Organizationall Assessment Community Member/Elder

Agency IC Tracking Number:

Is this a Common Form? No

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	Tribal Organizational Assessment Community Member-Elder Interview	Tribal Organizational Assessment Community Member-Elder 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: 12

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	12	12
Annual IC Time Burden (Hours)	12	12
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.