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New Director Mentor Program (NDMP) Feedback Surveys
Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0970-0401
IC ID: 239176
OMB.report
HHS/ACF
OMB 0970-0401
ICR 201801-0970-013
IC 239176
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:
2024-09-25 - No material or nonsubstantive change to a currently approved collection
2024-09-13 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
a. New Director Mentor Program (NDMP) Feedback Survey 1.6.20.docx
Other-Initial Survey
b. New Director Mentor Program (NDMP) Feedback Survey - 90 Day Check-In 12.31.2019.docx
Other-90 Day Check-in Survey
c. New Director Mentor Program (NDMP) Feedback Survey - Two-Thirds Check-In 1.6.20.docx
Other-2/3 Check-In Survey
d. New Director Mentor Program (NDMP) Feedback Survey - Final Check-In 12.31.2019.docx
Other-Final Check-In Survey
OMB Approval Request NDMP 1.6.20.docx
FastTrack Generic Submission Form - PMFO-UCLA NDMP Feedback Surveys
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
New Director Mentor Program (NDMP) Feedback Surveys
Agency IC Tracking Number:
OHS
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
Other-Initial Survey
a. New Director Mentor Program (NDMP) Feedback Survey 1.6.20.docx
No
Paper Only
Other-90 Day Check-in Survey
b. New Director Mentor Program (NDMP) Feedback Survey - 90 Day Check-In 12.31.2019.docx
Yes
Yes
Fillable Fileable
Other-2/3 Check-In Survey
c. New Director Mentor Program (NDMP) Feedback Survey - Two-Thirds Check-In 1.6.20.docx
Yes
Yes
Fillable Fileable
Other-Final Check-In Survey
d. New Director Mentor Program (NDMP) Feedback Survey - Final Check-In 12.31.2019.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
63
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
63
0
63
0
0
0
Annual IC Time Burden (Hours)
21
0
21
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
FastTrack Generic Submission Form - PMFO-UCLA NDMP Feedback Surveys
OMB Approval Request NDMP 1.6.20.docx
01/06/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.