Information Collection

Tribal Maternal, Infant, and Early Childhood Home Visiting (TMIECHV) Grantee Technical Assistance (TA) Needs Assessment

IC 245924 under ICR 202108-0970-004 · OMB 0970-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1-Self-Reflection Data Collection Tool 02-19-21.docx	Other-Needs Assessment
Instrument 1-Self-Reflection Data Collection Tool 02-19-21.docx	Other-Needs Assessment
Formative Data Collections for Program Support SSA 02-19-21_final.docx Supporting Statement A - Formative Program Support GenIC - TMIECHV Grantee TA Needs Assessment	IC Document
Formative Data Collections for Program Support SSA 02-19-21_final.docx Supporting Statement A - Formative Program Support GenIC - TMIECHV Grantee TA Needs Assessment	IC Document

IC Title:

Tribal Maternal, Infant, and Early Childhood Home Visiting (TMIECHV) Grantee Technical Assistance (TA) Needs Assessment

Agency IC Tracking Number:

OCC

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-Needs Assessment			Instrument 1-Self-Reflection Data Collection Tool 02-19-21.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: 38

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	38	38
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement A - Formative Program Support GenIC - TMIECHV Grantee TA Needs Assessment	Formative Data Collections for Program Support SSA 02-19-21_final.docx	02/19/2021

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