Information Collection

Foundational Assessment Survey-States, Courts, and Tribes

IC 224173 under ICR 201610-0970-005 · OMB 0970-0494.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0494 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Foundational Assessment Survey-States, Courts, and Tribes	Form and Instruction
1 Foundational Assessment Survey-Center for Courts Foundational Assessment Survey-Center for Courts.docx	Form and Instruction
1 Foundational Assessment Survey-Center for States Foundational Assessment Survey-Center for States.docx	Form and Instruction
1 Foundational Assessment Survey-Center for Tribes Foundational Assessment Survey-Center for Tribes.docx	Form and Instruction

IC Title:

Foundational Assessment Survey-States, Courts, and Tribes

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Foundational Assessment Survey-Center for Courts	Foundational Assessment Survey-Center for Courts.docx	Yes	Yes	Fillable Printable
Form and Instruction	1	Foundational Assessment Survey-Center for States	Foundational Assessment Survey-Center for States.docx	Yes	Yes	Fillable Printable
Form and Instruction	1	Foundational Assessment Survey-Center for Tribes	Foundational Assessment Survey-Center for Tribes.docx	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: 277

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	277	277
Annual IC Time Burden (Hours)	28	28
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.