Information Collection

State Capacity Building Center Tailored TA Feedback Collection for Impact Project

IC 227300 under ICR 201705-0970-010 · OMB 0970-0401.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 State Capacity Building Center Tailored TA Feedback Collection for Impact Project	Form and Instruction
1 SCBC Impact OCC OMB GC Request - SCBC Task 4 Impact - June 2017 Tool.docx	Form and Instruction
OCC OMB GC Request - SCBC Task 4 Impact - June 2017.docx Tailored TA Feedback Collection for Impact Project	IC Document

IC Title:

State Capacity Building Center Tailored TA Feedback Collection for Impact Project

Agency IC Tracking Number:

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	SCBC Impact	OCC OMB GC Request - SCBC Task 4 Impact - June 2017 Tool.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: 18

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	36	36
Annual IC Time Burden (Hours)	18	18
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Tailored TA Feedback Collection for Impact Project	OCC OMB GC Request - SCBC Task 4 Impact - June 2017.docx	06/27/2017

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