Information Collection

Cross-Center Tailored Services Jurisdiction Staff DEI Interview Protocol

IC 253559 under ICR 202205-0970-010 · OMB 0970-0576.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0576 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 34_Cross-Center – Tailored Services Jurisdiction Staff DEI Interview Protocol.docx	Other-Interview Protocol
Instrument 34_Cross-Center – Tailored Services Jurisdiction Staff DEI Interview Protocol.docx	Other-Interview Protocol

IC Title:

Cross-Center Tailored Services Jurisdiction Staff DEI Interview Protocol

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-Interview Protocol			Instrument 34_Cross-Center â Tailored Services Jurisdiction Staff DEI Interview Protocol.docx		Yes	Yes	Printable 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
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	8	8
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.