Information Collection

Staff Survey and Time Log

IC 243316 under ICR 202008-0970-015 · OMB 0970-0557.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0557 can be found here:

Documents and Forms

Document Name Document Type
Appendix_3_Staff Survey and Time Log_Parent Child Interaction Therapy Version_CLEAN.docx Other-Staff Survey and Time Log: Par
Appendix_4_Staff Survey and Time Log_Seeking Safety Version_CLEAN.docx Other-Staff Survey and Time Log: See
Appendix_5_Staff Survey and Time Log_Trauma Focused Cognitive Behavior Therapy_CLEAN.docx Other-Staff Survey and Time Log: Tra

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Staff Survey and Time Log	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Staff Survey and Time Log: Parent Child Interaction Therapy Version	Appendix_3_Staff Survey and Time Log_Parent Child Interaction Therapy Version_CLEAN.docx	Yes	Yes	Fillable Fileable
Other-Staff Survey and Time Log: Seeking Safety Version	Appendix_4_Staff Survey and Time Log_Seeking Safety Version_CLEAN.docx	Yes	Yes	Fillable Fileable
Other-Staff Survey and Time Log: Trauma Focused Cognitive Behavior Therapy Version	Appendix_5_Staff Survey and Time Log_Trauma Focused Cognitive Behavior Therapy_CLEAN.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: 90	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	90	90
Annual IC Time Burden (Hours)	330	330
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.