Information Collection

Assessing Models of Coordinated Services for Low-Income Children and Their Families (AMCS)

IC 237313 under ICR 201904-0970-003 · OMB 0970-0356.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0356 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
INSTRUMENT 1. State Model Profile v2.docx	Other-null
INSTRUMENT 2. Local Model Profile v2.docx	Other-null
INSTRUMENT 3. Request for Staffing Information.docx	Other-null
INSTRUMENT 4. State Telephone Interview Protocol.docx	Other-null
INSTRUMENT 5. Local Telephone Interview Protocol.docx	Other-null
Supporting Statement A - AMCS Study for OPRE Pilot with OIRA_July 2019 v6.docx Supporting Statement A - AMCS Study - Formative generic	IC Document
Supporting Statement B - AMCS Study for OPRE Pilot with OIRA_July 2019 v3.docx Supporting Statement B - AMCS Study - Formative generic	IC Document

IC Title:

Assessing Models of Coordinated Services for Low-Income Children and Their Families (AMCS)

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-null	INSTRUMENT 1. State Model Profile v2.docx	Yes	Yes	Fillable Fileable
Other-null	INSTRUMENT 2. Local Model Profile v2.docx	Yes	Yes	Fillable Fileable
Other-null	INSTRUMENT 3. Request for Staffing Information.docx	Yes	Yes	Fillable Fileable
Other-null	INSTRUMENT 4. State Telephone Interview Protocol.docx	No		Paper Only
Other-null	INSTRUMENT 5. Local Telephone Interview Protocol.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: 226

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	226	226
Annual IC Time Burden (Hours)	277	277
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement A - AMCS Study - Formative generic	Supporting Statement A - AMCS Study for OPRE Pilot with OIRA_July 2019 v6.docx	08/09/2019
Supporting Statement B - AMCS Study - Formative generic	Supporting Statement B - AMCS Study for OPRE Pilot with OIRA_July 2019 v3.docx	08/09/2019

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