Information Collection

Evaluation of the ACL Title VI Programs Title VI Program Staff Evaluation Follow-up Interview

IC 234844 under ICR 202008-0985-002 · OMB 0985-0059.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0059 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Evaluation of the ACL Title VI Programs Title VI Program Staff Evaluation Follow-up Interview	Form and Instruction
Title VI Program Staff Evaluation Follow-up Interview 0059 Evaluation follow up Consent and Guide.pdf	Form and Instruction
Title VI Evaluation Follow-up Consent and Guide 0059 Evaluation follow up consent and guide priv update.pdf	Form and Instruction

IC Title:

Evaluation of the ACL Title VI Programs Title VI Program Staff Evaluation Follow-up Interview

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Title VI Program Staff Evaluation Follow-up Interview	0059 Evaluation follow up Consent and Guide.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	NA	Title VI Evaluation Follow-up Consent and Guide	0059 Evaluation follow up consent and guide priv update.pdf		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: 12

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	12	-258	270
Annual IC Time Burden (Hours)	12	-482	494
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.