Information Collection

14 & 15 - Staff surveys

IC 220983 under ICR 201604-0970-003 · OMB 0970-0485.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0485 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
14 - B3 Staff Survey for Sites Testing Parenting Intervention.docx	Other-Survey
15 - B3 Staff Surveys for Sites Testing Employment Intervention.docx	Other-Survey
14 - Staff Survey for Sites Testing Parenting Intervention Screenshots.docx Staff Survey Screen Shots	IC Document

IC Title:

14 & 15 - Staff surveys

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
Other-Survey			14 - B3 Staff Survey for Sites Testing Parenting Intervention.docx		Yes	Yes	Fillable Fileable
Other-Survey			15 - B3 Staff Surveys for Sites Testing Employment Intervention.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: 80

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	80	80
Annual IC Time Burden (Hours)	53	53
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Staff Survey Screen Shots	14 - Staff Survey for Sites Testing Parenting Intervention Screenshots.docx	09/07/2016

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