Information Collection

PHAP Host Site Supervisor Survey

IC 226164 under ICR 201608-0920-018 · OMB 0920-1163.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1163 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PHAP Host Site Supervisor Survey	Form
PHAP Host Site Supervisor Survey Attachment C_PHAP Host Site Supervisor Survey_Web Version_updated 032317....pdf	Form
PHAP Host Site Supervisor Survey - word Attachment B_PHAP Host Site Supervisor Survey_Word Version_updated 03231....docx	Form
SSA+SSB_PHAP Host Site Supervisor Survey_3.15.17.docx Request for Approval - SSA- SSB	IC Document
Attachment D_PHAP Host Site Supervisor Survey_Email Invitation_031517.docx Invitation Email	IC Document
Attachment E_PHAP Host Site Supervisor Survey_Reminder Email_031517.docx Reminder Email	IC Document
Attachment F_PHAP Host Site Supervisor Survey_Reminder Email_031517.docx Reminder Email	IC Document
Attachment G_PHAP Host Site Supervisor Survey_Reminder Email_031517.docx Reminder Email	IC Document
Attachment A_PHAP Host Site Supervisor Survey Respondent Information_031....docx Respondent Description	IC Document
Non-Research Determination_PHAP Host Site Supervisor Survey.pdf Non-research Determination	IC Document

IC Title:

PHAP Host Site Supervisor Survey

Agency IC Tracking Number:

17AAL

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	none	PHAP Host Site Supervisor Survey	Attachment C_PHAP Host Site Supervisor Survey_Web Version_updated 032317....pdf		Yes	Yes	Fillable Fileable
Form	none	PHAP Host Site Supervisor Survey - word	Attachment B_PHAP Host Site Supervisor Survey_Word Version_updated 03231....docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	133	133
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval - SSA- SSB	SSA+SSB_PHAP Host Site Supervisor Survey_3.15.17.docx	03/23/2017
Invitation Email	Attachment D_PHAP Host Site Supervisor Survey_Email Invitation_031517.docx	03/23/2017
Reminder Email	Attachment E_PHAP Host Site Supervisor Survey_Reminder Email_031517.docx	03/23/2017
Reminder Email	Attachment F_PHAP Host Site Supervisor Survey_Reminder Email_031517.docx	03/23/2017
Reminder Email	Attachment G_PHAP Host Site Supervisor Survey_Reminder Email_031517.docx	03/23/2017
Respondent Description	Attachment A_PHAP Host Site Supervisor Survey Respondent Information_031....docx	03/23/2017
Non-research Determination	Non-Research Determination_PHAP Host Site Supervisor Survey.pdf	03/23/2017

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