Information Collection

Study on the impact of COVID-19 on Adult Protective Service (APS) Programs

IC 242584 under ICR 202101-0985-001 · OMB 0985-0067.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Phase I Study on the impact of COVID-19 on Adult Protective Service (APS) Programs	Form and Instruction
Phase I Phase I State Administrator Interview 0067 Phase I State Administrator Interview.pdf	Form and Instruction
Phase I Phase I State Administrator Interview 0067 Phase I State Administrator Interview.pdf	Form and Instruction
Phase II Local Field Staff Interview 0067 Phase II Local Field Staff Interview.pdf	Form and Instruction
Phase II Local Field Staff Interview 0067 Phase II Local Field Staff Interview.pdf	Form and Instruction

IC Title:

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	Phase I	Phase I State Administrator Interview	0067 Phase I State Administrator Interview.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	Phase II	Local Field Staff Interview	0067 Phase II Local Field Staff Interview.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: 72

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	72	22	50
Annual IC Time Burden (Hours)	54	38	16
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.