Information Collection

Pre-testing Request for Strengthening Relationship Education and Marriage Services (STREAMS)

IC 232972 under ICR 201802-0970-003 · OMB 0970-0355.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0355 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1_Facilitator Self Assessment Form_8-23-18.docx	Other-Facilitator Self Assessment
STREAMS generic pretesting OMB SSA_8-23-18.docx STREAMS generic pretesting OMB SSA_8-23-18	IC Document
STREAMS generic prestesting OMB SSB_8-23-18.docx STREAMS generic prestesting OMB SSB_8-23-18	IC Document
Attachment A_STREAMS_Legislative authority.pdf Attachment A_STREAMS_Legislative authority	IC Document
Attachment B_STREAMS confidentiality pledge.pdf Attachment B_STREAMS confidentiality pledge	IC Document

IC Title:

Pre-testing Request for Strengthening Relationship Education and Marriage Services (STREAMS)

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-Facilitator Self Assessment			Instrument 1_Facilitator Self Assessment Form_8-23-18.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: 16

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	864	864
Annual IC Time Burden (Hours)	173	173
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
STREAMS generic pretesting OMB SSA_8-23-18	STREAMS generic pretesting OMB SSA_8-23-18.docx	09/11/2018
STREAMS generic prestesting OMB SSB_8-23-18	STREAMS generic prestesting OMB SSB_8-23-18.docx	09/11/2018
Attachment A_STREAMS_Legislative authority	Attachment A_STREAMS_Legislative authority.pdf	09/11/2018
Attachment B_STREAMS confidentiality pledge	Attachment B_STREAMS confidentiality pledge.pdf	09/11/2018

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