Information Collection

Rigorous Evaluation Technical Assistance (RETA) Feedback Form

IC 229526 under ICR 201706-0970-005 · 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⚠️ Notice: This information collection may be referencing outdated material.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
RETA - Feedback Form - Clean - 12-20-17.docx	Other-Word template
Fast Track Generic - RETA Feedback Form - 12-20-17.doc RETA Fast Track Generic Submission Template	IC Document

IC Title:

Rigorous Evaluation Technical Assistance (RETA) Feedback Form

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
Other-Word template			RETA - Feedback Form - Clean - 12-20-17.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 126

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	126	126
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
RETA Fast Track Generic Submission Template	Fast Track Generic - RETA Feedback Form - 12-20-17.doc	12/20/2017

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