National Center on Early Childhood Health and Wellness (NCECHW) Infoline Feedback Form

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Document Name Document Type
Infoline-NCECHW-Feedback-Form-8-1-19.docx Other-
Infoline Fast Track OMB Approval Request_8-1-19.docx Fast Track Submission Form - NCECHW Infoline Feedback Form IC Document

Information Collection (IC) Details

IC Title:	National Center on Early Childhood Health and Wellness (NCECHW) Infoline Feedback Form	Agency IC Tracking Number:

IC Status: Unchanged

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-			Infoline-NCECHW-Feedback-Form-8-1-19.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 360	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	360	360
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Submission Form - NCECHW Infoline Feedback Form	Infoline Fast Track OMB Approval Request_8-1-19.docx	08/02/2019

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