Information Collection

Hennepin County (child welfare) – Phase 3 Data Collection

IC 254076 under ICR 202206-0970-002 · OMB 0970-0502.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0502 can be found here:

Documents and Forms

Document Name Document Type
BIAS NG HC OMB_Instrument 1_Family.docx Other-Interview/Focus Group
BIAS NG HC OMB_Instrument 1_Family.docx Other-Interview/Focus Group
BIAS NG HC OMB_Instrument 2_Staff.docx Other-Interview/Focus Group
BIAS NG HC OMB_Instrument 2_Staff.docx Other-Interview/Focus Group
OMB_BIAS NG HC_SSA_4.4.22_clean.docx SSA - BIAS-NG GenIC: Hennepin County (child welfare) IC Document
OMB_BIAS NG HC_SSA_4.4.22_clean.docx SSA - BIAS-NG GenIC: Hennepin County (child welfare) IC Document
OMB_BIAS NG HC_SSB_4_6_22_clean.docx SSB - BIAS-NG GenIC: Hennepin County (child welfare) IC Document
OMB_BIAS NG HC_SSB_4_6_22_clean.docx SSB - BIAS-NG GenIC: Hennepin County (child welfare) IC Document
NOA_BIAS NG GenIC_Hennepin Cnty CW_0970-0502_5.13.22.pdf NOA - BIAS-NG GenIC: Hennepin County (child welfare) IC Document
NOA_BIAS NG GenIC_Hennepin Cnty CW_0970-0502_5.13.22.pdf NOA - BIAS-NG GenIC: Hennepin County (child welfare) IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Hennepin County (child welfare) â Phase 3 Data Collection	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Interview/Focus Group			BIAS NG HC OMB_Instrument 1_Family.docx		Yes	Yes	Printable Only
Other-Interview/Focus Group			BIAS NG HC OMB_Instrument 2_Staff.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: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA - BIAS-NG GenIC: Hennepin County (child welfare)	OMB_BIAS NG HC_SSA_4.4.22_clean.docx	06/07/2022
SSB - BIAS-NG GenIC: Hennepin County (child welfare)	OMB_BIAS NG HC_SSB_4_6_22_clean.docx	06/07/2022
NOA - BIAS-NG GenIC: Hennepin County (child welfare)	NOA_BIAS NG GenIC_Hennepin Cnty CW_0970-0502_5.13.22.pdf	06/07/2022

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