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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

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/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 %

table that charts list of burden
	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

table that charts IC Documents
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.