Information Collection

14 & 15 - Staff surveys

IC 220983 under ICR 201710-0970-002 · OMB 0970-0485.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
14 - B3 Staff Survey for Sites Testing Parenting Intervention_OMB Approved_8.2017Revisions_Clean.docx	Other-Survey
15 - B3 Staff Surveys for Sites Testing Employment Intervention_OMB Approved_8.2017Revisions_Clean.docx	Other-Survey
14 - Staff Survey for Sites Testing Parenting Intervention Screenshots.docx Staff Survey Screen Shots	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-Survey					Yes	Yes	Fillable Fileable
Other-Survey					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: 80

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	Previously Approved
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	53	53
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Staff Survey Screen Shots		09/07/2016

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].