Information Collection

Center for States Internal Evaluation: Interviews with Jurisdictions

IC 244239 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⚠️ Notice: This information collection may be referencing outdated material.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
Jurisdiction Interview Protocol_interviewer and note taker_revised 10.12.20.docx	Other-Interview Guide
Jurisdiction Interview Protocol_interviewer and note taker_revised 10.12.20.docx	Other-Interview Guide
Center.for.States_Interview_Protocol_OMB.FastTrackApplication_10.13.20.docx Fast Track Form: Center for States Internal Evaluation Interviews_2020	IC Document
Center.for.States_Interview_Protocol_OMB.FastTrackApplication_10.13.20.docx Fast Track Form: Center for States Internal Evaluation Interviews_2020	IC Document

IC Title:

Center for States Internal Evaluation: Interviews with Jurisdictions

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
Other-Interview Guide			Jurisdiction Interview Protocol_interviewer and note taker_revised 10.12.20.docx		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Form: Center for States Internal Evaluation Interviews_2020	Center.for.States_Interview_Protocol_OMB.FastTrackApplication_10.13.20.docx	10/26/2020

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