Adoption Triad Survey

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 1 Adoption Triad Survey Form and Instruction
1 Adoption Triad Adoption Triad_DRAFT survey_final.docx Form and Instruction
fast-track-PRA-submission-short-form_CWIG Adoption Triad Survey_final.doc Adoption Triad Survey IC Document

Information Collection (IC) Details

IC Title:	Adoption Triad Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Adoption Triad	Adoption Triad_DRAFT survey_final.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: 595	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	595	595
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Adoption Triad Survey	fast-track-PRA-submission-short-form_CWIG Adoption Triad Survey_final.doc	07/10/2017

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