Information Collection

Evaluation of Older Americans Act Title VI - Tribal Elders Focus Group

IC 227558 under ICR 201902-0985-001 · OMB 0985-0059.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0059 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4 Evaluation of Older Americans Act Title VI - Tribal Elders Focus Group	Form and Instruction
4 Title VI Elders Focus Group Title VI Tribal Elders Focus Group Moderator Guide.docx	Form and Instruction
4 Tribal Elder Focus Group Consent Form Title VI Tribal Elder Focus Group Consent-2-2.docx	Form

IC Title:

Evaluation of Older Americans Act Title VI - Tribal Elders Focus Group

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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
Form and Instruction	4	Title VI Elders Focus Group	Title VI Tribal Elders Focus Group Moderator Guide.docx		No		Printable Only
Form	4	Tribal Elder Focus Group Consent Form	Title VI Tribal Elder Focus Group Consent-2-2.docx		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-100	100
Annual IC Time Burden (Hours)	-200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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