Information Collection

Direct assessments of caregivers - MIHOPE-K

IC 231390 under ICR 202109-0970-018 · OMB 0970-0402.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0402 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SSA Attachment 4 MIHOPE-K Direct assessments of caregivers_updated 9.21_CLEAN.docx	Other-Direct Assessment Protocol
SSA Attachment 4 MIHOPE-K Direct assessments of caregivers_updated 9.21_CLEAN.docx	Other-Direct Assessment Protocol

IC Title:

Direct assessments of caregivers - MIHOPE-K

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-Direct Assessment Protocol			SSA Attachment 4 MIHOPE-K Direct assessments of caregivers_updated 9.21_CLEAN.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: 1,391

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,391	19	1,372
Annual IC Time Burden (Hours)	236	3	233
Annual IC Cost Burden (Dollars)	0	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.