Information Collection

Instrument 3 - Implementation interview: Center Director & Additional Center Staff

IC 226923 under ICR 201909-0970-004 · OMB 0970-0499.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0499 can be found here:

Documents and Forms

Document Name Document Type
Instrument 3. Implementation protocol.docx Other-Impl Data Collection Combined

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Instrument 3 - Implementation interview: Center Director & Additional Center Staff	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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-Impl Data Collection Combined			Instrument 3. Implementation 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: 100	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 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.