Center for States 2020 Needs Assessment Survey

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Document Name Document Type
CenterforStatesNeedsAssessmentSurvey_final.docx Other-Survey
CenterforStatesNeedsAssessmentSurvey_OMBFastTrackApplication_final.docx FastTrack Submission Form - Center for States 2020 Needs Assessment Survey IC Document

Information Collection (IC) Details

IC Title:	Center for States 2020 Needs Assessment Survey	Agency IC Tracking Number:	CB

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-Survey			CenterforStatesNeedsAssessmentSurvey_final.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: 200	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
FastTrack Submission Form - Center for States 2020 Needs Assessment Survey	CenterforStatesNeedsAssessmentSurvey_OMBFastTrackApplication_final.docx	02/28/2020

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