Information Collection

Center-based Provider Interview Wave 2 Fall; Providers completing Wave 2 Spring interview also

IC 247772 under ICR 202106-0970-003 · OMB 0970-0391.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0391 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1 NSECE COVID-19 Follow-up Center-based Provider Questionnaire Wave 2_050321_toOPRE - clean.docx	Other-Questionnaire
Instrument 1 NSECE COVID-19 Follow-up Center-based Provider Questionnaire Wave 2_050321_toOPRE - clean.docx	Other-Questionnaire

IC Title:

Center-based Provider Interview Wave 2 Fall; Providers completing Wave 2 Spring interview also

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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-Questionnaire			Instrument 1 NSECE COVID-19 Follow-up Center-based Provider Questionnaire Wave 2_050321_toOPRE - 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: 1,136

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
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,136	1,136
Annual IC Time Burden (Hours)	329	329
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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