Information Collection

Instrument 3: Parent consent form

IC 227598 under ICR 202009-0970-003 · OMB 0970-0354.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0354 can be found here:

Documents and Forms

Document Name Document Type
A3. Parent Consent Form_June2020_clean.docx Other-Consent (2021)
A3. Parent Consent Form_02-21-2020CLEAN.pdf Other-Consent (2020)

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Instrument 3: Parent consent form	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-Consent (2021)			A3. Parent Consent Form_June2020_clean.docx		Yes	Yes	Fillable Fileable
Other-Consent (2020)			A3. Parent Consent Form_02-21-2020CLEAN.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: 3,234	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,617	369	1,248
Annual IC Time Burden (Hours)	276	64	212
Annual IC Cost Burden (Dollars)	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.