Information Collection

Tribal Home Visiting Technical Assistance Evaluation Feedback and Immediate Feedback Forms

IC 238491 under ICR 201801-0970-013 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Fast Track Generic Feedback PATH TA Immediate Feedback Form Instrument 2019_final.docx	Other-null
Fast Track Generic Feedback PATH Annual TA Feedback Form Instrument 2019.docx	Other-null
PATH II Gen. Clearance.Annual TA Feedback Tools_Submission Form_11.4.19.rtf Fast Track Submission Form - PATH Annual TA Feedback	IC Document

IC Title:

Tribal Home Visiting Technical Assistance Evaluation Feedback and Immediate Feedback Forms

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-null			Fast Track Generic Feedback PATH TA Immediate Feedback Form Instrument 2019_final.docx		Yes	Yes	Fillable Fileable
Other-null			Fast Track Generic Feedback PATH Annual TA Feedback Form Instrument 2019.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: 23

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	115	115
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Submission Form - PATH Annual TA Feedback	PATH II Gen. Clearance.Annual TA Feedback Tools_Submission Form_11.4.19.rtf	11/08/2019

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