Information Collection

New Director Mentor Program (NDMP) Feedback Surveys

IC 239176 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⚠️ Notice: This information collection may be referencing outdated material.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
a. New Director Mentor Program (NDMP) Feedback Survey 1.6.20.docx	Other-Initial Survey
a. New Director Mentor Program (NDMP) Feedback Survey 1.6.20.docx	Other-Initial Survey
b. New Director Mentor Program (NDMP) Feedback Survey - 90 Day Check-In 12.31.2019.docx	Other-90 Day Check-in Survey
b. New Director Mentor Program (NDMP) Feedback Survey - 90 Day Check-In 12.31.2019.docx	Other-90 Day Check-in Survey
c. New Director Mentor Program (NDMP) Feedback Survey - Two-Thirds Check-In 1.6.20.docx	Other-2/3 Check-In Survey
c. New Director Mentor Program (NDMP) Feedback Survey - Two-Thirds Check-In 1.6.20.docx	Other-2/3 Check-In Survey
d. New Director Mentor Program (NDMP) Feedback Survey - Final Check-In 12.31.2019.docx	Other-Final Check-In Survey
d. New Director Mentor Program (NDMP) Feedback Survey - Final Check-In 12.31.2019.docx	Other-Final Check-In Survey
OMB Approval Request NDMP 1.6.20.docx FastTrack Generic Submission Form - PMFO-UCLA NDMP Feedback Surveys	IC Document
OMB Approval Request NDMP 1.6.20.docx FastTrack Generic Submission Form - PMFO-UCLA NDMP Feedback Surveys	IC Document

IC Title:

New Director Mentor Program (NDMP) Feedback Surveys

Agency IC Tracking Number:

OHS

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Initial Survey	a. New Director Mentor Program (NDMP) Feedback Survey 1.6.20.docx	No		Paper Only
Other-90 Day Check-in Survey	b. New Director Mentor Program (NDMP) Feedback Survey - 90 Day Check-In 12.31.2019.docx	Yes	Yes	Fillable Fileable
Other-2/3 Check-In Survey	c. New Director Mentor Program (NDMP) Feedback Survey - Two-Thirds Check-In 1.6.20.docx	Yes	Yes	Fillable Fileable
Other-Final Check-In Survey	d. New Director Mentor Program (NDMP) Feedback Survey - Final Check-In 12.31.2019.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: 63

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	63	63
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
FastTrack Generic Submission Form - PMFO-UCLA NDMP Feedback Surveys	OMB Approval Request NDMP 1.6.20.docx	01/06/2020

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