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			14 - B3 Staff Survey for Sites Testing Parenting Intervention_OMB Approved_8.2017Revisions_Clean.docx		Yes	Yes	Fillable Fileable
Other-Survey			15 - B3 Staff Surveys for Sites Testing Employment Intervention_OMB Approved_8.2017Revisions_Clean.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: 80

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

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	14 - Staff Survey for Sites Testing Parenting Intervention Screenshots.docx	09/07/2016

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