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Baseline information form for participants (Attachment D)
OPRE Evaluation - Building Evidence on Employment Strategies for Low-Income Families (BEES) [Impact, implementation, and descriptive studies]
OMB: 0970-0537
IC ID: 235592
OMB.report
HHS/ACF
OMB 0970-0537
ICR 202002-0970-007
IC 235592
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0537 can be found here:
2024-05-01 - No material or nonsubstantive change to a currently approved collection
2023-12-13 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
BEES _NonSub Change Request_Attachment D-Generic BIF CLEAN_Feb 2020.docx
Other-Standard BIF
BEES_NonSub Change Request_Attachment D-1-ARC BIF CLEAN_Feb 2020.docx
Other-Tailored BIF - ARC Site
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Baseline information form for participants (Attachment D)
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-Standard BIF
BEES _NonSub Change Request_Attachment D-Generic BIF CLEAN_Feb 2020.docx
Yes
Yes
Fillable Fileable
Other-Tailored BIF - ARC Site
BEES_NonSub Change Request_Attachment D-1-ARC BIF CLEAN_Feb 2020.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,133
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
4,133
0
0
0
0
4,133
Annual IC Time Burden (Hours)
1,034
0
0
0
0
1,034
Annual IC Cost Burden (Dollars)
0
0
0
0
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.