Information Collection

Community Catalyst (CCI) Program Evaluation

IC 234460 under ICR 201905-3137-003 · OMB 3137-0113.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3137-0113 can be found here:

2022-11-30 - Reinstatement without change of a previously approved collection

Documents and Forms

Document Name Document Type
Form Form 6 Community Catalyst (CCI) Program Evaluation Form and Instruction
Form 1 CCI Case Study Protocol CCI Case Study Protocol 11.25.2018.docx Form and Instruction
Form 2 CCI Local Partner Survey CCI Eval Survey for Local Partner Orgs (C1 & C2FU) V2.pdf Form and Instruction
From 3 CCI Local Partner Survey Cohort Two CCI Eval Survey for Local Partner Orgs (C2B) V2.pdf Form and Instruction
Form 4 CCI Museum and Library Survey CCI Eval Survey for Museums Libs Other Grantees (C1) V2.pdf Form and Instruction
Form 5 CCI Museum and Library Survey Cohort Two CCI Eval Survey for Museums Libs Other Grantees (C2B) V2.pdf Form and Instruction
Form 6 CCI Museum and Library Survey Follow Up CCI Eval Survey for Museums Libs Other Grantees (C2FU) V2.pdf Form and Instruction
Form 7 CCI Project Team Interview Protocol CCI Project Team Interview Protocol 11.25.18.docx Form and Instruction
Form 8 CCI Local Partner Survey Revised CCI Eval Survey for Local Partner Orgs (C1 C2FU)_proposed NS changes.docx Form and Instruction
Form 9 CCI Museum and Library Survey Revised CCI Eval Survey for Museums Libs Other Grantees (C1)_proposed NS changes.docx Form and Instruction
Theory of Change Visual (Part A).pdf CCI Theory of Change IC Document
CCI Project Research References.docx CCI Research References IC Document
CCI Evaluation Survey Link Messages and Reminders 11.28.18.docx CCI Survey Link and Correspondence IC Document
Justification for Nonsubstantive Change CCI 2019-05-17.docx Justification for Nonsubstantive Change Request IC Document
Proposed Changes to CCI Evaluation Surveys 05.03.19.docx Matrix of Survey Changes Proposed IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Community Catalyst (CCI) Program Evaluation	Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form 6	CCI Museum and Library Survey Follow Up	CCI Eval Survey for Museums Libs Other Grantees (C2FU) V2.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	Form 7	CCI Project Team Interview Protocol	CCI Project Team Interview Protocol 11.25.18.docx	Yes	No	Fillable Printable
Form and Instruction	Form 8	CCI Local Partner Survey Revised	CCI Eval Survey for Local Partner Orgs (C1 C2FU)_proposed NS changes.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Form 9	CCI Museum and Library Survey Revised	CCI Eval Survey for Museums Libs Other Grantees (C1)_proposed NS changes.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Form 1	CCI Case Study Protocol	CCI Case Study Protocol 11.25.2018.docx	Yes	No	Fillable Printable
Form and Instruction	Form 2	CCI Local Partner Survey	CCI Eval Survey for Local Partner Orgs (C1 & C2FU) V2.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	From 3	CCI Local Partner Survey Cohort Two	CCI Eval Survey for Local Partner Orgs (C2B) V2.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	Form 4	CCI Museum and Library Survey	CCI Eval Survey for Museums Libs Other Grantees (C1) V2.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	Form 5	CCI Museum and Library Survey Cohort Two	CCI Eval Survey for Museums Libs Other Grantees (C2B) V2.pdf	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 599	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	599	599
Annual IC Time Burden (Hours)	524	524
Annual IC Cost Burden (Dollars)	16,610	16,610

Documents for IC

Title	Document	Date Uploaded
CCI Theory of Change	Theory of Change Visual (Part A).pdf	12/10/2018
CCI Research References	CCI Project Research References.docx	12/10/2018
CCI Survey Link and Correspondence	CCI Evaluation Survey Link Messages and Reminders 11.28.18.docx	12/10/2018
Justification for Nonsubstantive Change Request	Justification for Nonsubstantive Change CCI 2019-05-17.docx	05/17/2019
Matrix of Survey Changes Proposed	Proposed Changes to CCI Evaluation Surveys 05.03.19.docx	05/17/2019

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