Information Collection

FY2019 New Capacity Building Center for States Community of Practice: County Administered State Support Interest Survey

IC 237065 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⚠️ Notice: This information collection may be referencing outdated material.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
CBCSCoPCountySystems_InterestSurvey_7-23-19.docx	Other-Interest Survey
CBCSCoPCountySystems_InterestSurvey_7-23-19.docx	Other-Interest Survey
CountyBasedCWSystemSurvey_OMBFastTrack_7-23-19.doc Fast Track Submission Form - FY19 New Capacity Building Center for States Community of Practice: County Administered State Suppo	IC Document
CountyBasedCWSystemSurvey_OMBFastTrack_7-23-19.doc Fast Track Submission Form - FY19 New Capacity Building Center for States Community of Practice: County Administered State Suppo	IC Document

IC Title:

FY2019 New Capacity Building Center for States Community of Practice: County Administered State Support Interest Survey

Agency IC Tracking Number:

ACYF

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
Other-Interest Survey			CBCSCoPCountySystems_InterestSurvey_7-23-19.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: 45

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	Previously Approved
Annual Number of Responses for this IC	45	45
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Submission Form - FY19 New Capacity Building Center for States Community of Practice: County Administered State Support Interest Survey	CountyBasedCWSystemSurvey_OMBFastTrack_7-23-19.doc	07/24/2019

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