Information Collection

Strengthening the Implementation of Marriage and Relationship Programs (SIMR) - Evaluation Plan Template (SECOND SIMR SUBMISSION)

IC 245246 under ICR 202105-0970-004 · OMB 0970-0356.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0356 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix A_SIMR OMB_Evaluation Plan Template_12-14-20_clean.docx	Other-Template
Appendix A_SIMR OMB_Evaluation Plan Template_12-14-20_clean.docx	Other-Template
Appendix B_SIMR OMB_Evaluation Plan Template Instructions_12-14-20_clean.docx	Instruction
Appendix B_SIMR OMB_Evaluation Plan Template Instructions_12-14-20_clean.docx	Instruction
50898 SIMR_OMB_EvalPlans_StatementA_12-15-20_clean_final.docx SSA - GenIC SIMR Eval Plan Template	IC Document
50898 SIMR_OMB_EvalPlans_StatementA_12-15-20_clean_final.docx SSA - GenIC SIMR Eval Plan Template	IC Document
Appendix C_SIMR OMB_Evaluation Plan Email Template_12-14-20_clean.docx Appendix C - Email	IC Document
Appendix C_SIMR OMB_Evaluation Plan Email Template_12-14-20_clean.docx Appendix C - Email	IC Document
NOA_SIMR Eval Template_12.17.2020.pdf NOA - SIMR Eval Plan Template	IC Document
NOA_SIMR Eval Template_12.17.2020.pdf NOA - SIMR Eval Plan Template	IC Document

IC Title:

Strengthening the Implementation of Marriage and Relationship Programs (SIMR) - Evaluation Plan Template (SECOND SIMR SUBMISSION)

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-Template			Appendix A_SIMR OMB_Evaluation Plan Template_12-14-20_clean.docx		Yes	Yes	Fillable Fileable
Instruction			Appendix B_SIMR OMB_Evaluation Plan Template Instructions_12-14-20_clean.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: 43

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 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	43	43
Annual IC Time Burden (Hours)	344	344
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - GenIC SIMR Eval Plan Template	50898 SIMR_OMB_EvalPlans_StatementA_12-15-20_clean_final.docx	01/07/2021
Appendix C - Email	Appendix C_SIMR OMB_Evaluation Plan Email Template_12-14-20_clean.docx	01/07/2021
NOA - SIMR Eval Plan Template	NOA_SIMR Eval Template_12.17.2020.pdf	01/07/2021

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