OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Potential PFL-eligible low-income mothers

IC 219524 under ICR 201704-0990-001 · OMB 0990-0421.

Documents and Forms
Document Name
Document Type
Other-focus groups
Other-survey
Other-questions
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Potential PFL-eligible low-income mothers
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-focus groups 0990-0421 revisedFocus Groups guide Attach B_Final.docx No   Paper Only
Other-survey 0990-0421 revisedPhone_Screen_Attach A_Final.docx No   Printable Only
Other-questions 0990-0421 revisedPFL DemoQuestion Attach C_Final.docx No   Paper Only

Health Health Care Services

 

80 0
   
Individuals or Households
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 80 0 0 0 0 80
Annual IC Time Burden (Hours) 73 0 0 0 0 73
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SS part B: Exploring the Relationship between the CA Paid Family Leave Program and the Well-Being of Low-Income Families 0990-0421 revisedSupportingStatementB_PFL_Final.docx 01/13/2016
Support St. A: Exploring the Relationship between the CA Paid Family Leave Program and the Well-Being of Low-Income Families 0990-0421 revised2SupportingStatementA_PFL_Final.docx 01/13/2016
Mini SS: Exploring the Relationship between the CA Paid Family Leave Program and the Well-Being of Low-Income Families 0990-0421 revised2ASPE Generic - Short Supporting Statement cover sheet_PFL Project _FINAL.docx 01/13/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.