Information Collection

Maternal, Infant, and Early Childhood Home Visiting (MIECHV) TA Satisfaction Survey

IC 230089 under ICR 202105-0970-001 · OMB 0970-0401.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Maternal, Infant, and Early Childhood Home Visiting (MIECHV) TA Satisfaction Survey	Form and Instruction
1 DOHVE 2 DOHVE 2 Satisfaction Survey 1.30.18_mj_clean.docx	Form and Instruction
1 DOHVE 2 DOHVE 2 Satisfaction Survey 1.30.18_mj_clean.docx	Form and Instruction
DOHVE 2 Fast Track Generic - Submission Template_TA Satisfaction. 01-30-18. doc (2).doc Justification	IC Document
DOHVE 2 Fast Track Generic - Submission Template_TA Satisfaction. 01-30-18. doc (2).doc Justification	IC Document

IC Title:

Maternal, Infant, and Early Childhood Home Visiting (MIECHV) TA Satisfaction Survey

Agency IC Tracking Number:

IC Status: Unchanged

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	1	DOHVE 2	DOHVE 2 Satisfaction Survey 1.30.18_mj_clean.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification	DOHVE 2 Fast Track Generic - Submission Template_TA Satisfaction. 01-30-18. doc (2).doc	02/13/2018

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