Information Collection

Head Start Family Background Questionnaire

IC 244659 under ICR 202011-0970-012 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1—Head Start Family Background Questionnaire 11.16.2020.docx	Other-Head Start Family Background Q
Instrument 1—Head Start Family Background Questionnaire 11.16.2020.docx	Other-Head Start Family Background Q

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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
Other-Head Start Family Background Questionnaire			Instrument 1âHead Start Family Background Questionnaire 11.16.2020.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: 48

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	48	48
Annual IC Time Burden (Hours)	12	12
Annual IC Cost Burden (Dollars)	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.