Information Collection

Fatherhood Family-Focused, Interconnected, Resilient, and Essential (Fatherhood FIRE) Grantee Local Evaluation Plan Template

IC 245247 under ICR 202101-0970-001 · OMB 0970-0356.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0356 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument_Fatherhood FIRE Evaluation Plan Template_rev3_updated CLEAN.docx	Other-Template
Instrument_Fatherhood FIRE Evaluation Plan Template_rev3_updated CLEAN.docx	Other-Template
Generic SSA - Fatherhood FIRE Grantee Local Evaluation Plan Template_rev3_KP 121420 updated CLEAN.docx SSA - Formative GenIC ACF Research - Fatherhood FIRE Template	IC Document
Generic SSA - Fatherhood FIRE Grantee Local Evaluation Plan Template_rev3_KP 121420 updated CLEAN.docx SSA - Formative GenIC ACF Research - Fatherhood FIRE Template	IC Document
NOA_Fatherhood FIRE_12.17.2020.pdf NOA - Fatherhood FIRE Eval Plan Template	IC Document
NOA_Fatherhood FIRE_12.17.2020.pdf NOA - Fatherhood FIRE Eval Plan Template	IC Document

IC Title:

Fatherhood Family-Focused, Interconnected, Resilient, and Essential (Fatherhood FIRE) Grantee Local Evaluation Plan Template

Agency IC Tracking Number:

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-Template			Instrument_Fatherhood FIRE Evaluation Plan Template_rev3_updated 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: 42

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

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	42	42
Annual IC Time Burden (Hours)	336	336
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - Formative GenIC ACF Research - Fatherhood FIRE Template	Generic SSA - Fatherhood FIRE Grantee Local Evaluation Plan Template_rev3_KP 121420 updated CLEAN.docx	01/07/2021
NOA - Fatherhood FIRE Eval Plan Template	NOA_Fatherhood FIRE_12.17.2020.pdf	01/07/2021

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