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Coaching Companion Questionnaire
Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0970-0401
IC ID: 238489
OMB.report
HHS/ACF
OMB 0970-0401
ICR 202105-0970-001
IC 238489
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:
2024-09-25 - No material or nonsubstantive change to a currently approved collection
2024-09-13 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Coaching Companion Questionnaire.docx
Other-Survey
Coaching Companion Questionnaire.docx
Other-Survey
OMB Approval Request - Coaching Companion Questionnaire.docx
Fast Track Submission Form - Coaching Companion Survey
IC Document
OMB Approval Request - Coaching Companion Questionnaire.docx
Fast Track Submission Form - Coaching Companion Survey
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Coaching Companion Questionnaire
Agency IC Tracking Number:
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Survey
Coaching Companion Questionnaire.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
350
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 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
350
0
0
0
0
350
Annual IC Time Burden (Hours)
41
0
0
0
0
41
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Fast Track Submission Form - Coaching Companion Survey
OMB Approval Request - Coaching Companion Questionnaire.docx
11/08/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.