Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Final - Part A_Family Options.docx	Supporting Statement A	Uploaded 2022-09-15	Repair queued
30 day FRN.pdf	Supplementary Document	Uploaded 2022-09-13	Repair queued
Final - Part B_Family Options (002).docx	Supporting Statement B	Uploaded 2022-09-13	Repair queued
Appendix O_60 Day FR Notice.pdf	Supplementary Document	Uploaded 2022-06-10	Repair queued
Family Options Study_Appendix E.pdf	Supplementary Document	Uploaded 2022-02-15	Repair queued
SORN Family Options Study-.pdf	Supplementary Document	Uploaded 2017-05-26	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
255862	Adult Child Survey (Appendix M)	Other-Adult Child Survey (Appendix M)	New
255861	Adult Child E-mail Invitation (Appendix L)	Other-Adult Child E-mail Invitation (Appendix L)	New
255860	Adult Child Information Release Form (Appendix K)	Other-Adult Child Information Release Form (Appendix K)	New
255859	Consent to Participate- Adult Child (Appendix J)	Other-Consent to Participate- Adult Child (Appendix J)	New
255858	Adult Child Enrollment Call (Appendix I)	Other-Adult Child Enrollment Call (Appendix I)	New
255857	Child Survey (Appendix H)	Other-Child Survey (Appendix H)	New
255856	Child Assent Form (Appendix G)	Other-Child Assent Form (Appendix G)	New
255853	Parent Permission Form (Appendix F)	Other-Parent Permission Form (Appendix F)	New
255852	Adult Head of Household Survey (Appendix E)	Other-Adult Head of Household Survey (Appendix E)	New
255851	Consent to Participate- Adult Respondent (Appendix D)	Other-Consent to Participate- Adult Respondent (Appendix D)	New
255838	Adult Head of Household Outreach Flyer (Appendix C)	Other-Adult Head of Household Outreach Flyer (Appendix C)	New
255836	Adult Head of Household Outreach E-mail (Appendix B)	Other-Adult Head of Household Outreach E-mail (Appendix B)	New
255835	Adult Head of Household Advance Letter (Appendix A)	Other-Adult Head of Household Advance Letter (Appendix A)	New
251607	Information Release Form	Other-Information Release Form	Removed
251602	12 Year Tracking Survey	Other-12 Year Tracking Survey	Removed
251599	Welcome Back Newsletter and Participant Contact Update Form	Other-Welcome Back Newsletter and Participant Contact Update For	Removed

ICR Details

OMB Control No:	ICR Reference No:
Status:	Previous ICR Reference No:
Agency/Subagency:	Agency Tracking No:
Title:
Type of Information Collection:	Common Form ICR:
Type of Review Request:	Date Received in OIRA:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract:

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR?

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Number of Information Collection (IC) in this ICR: 0

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ICR Summary of Burden

table that charts list of burden

	Total	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	0	0	0	0	0	0
Annual Time Burden (Hours)	0	0	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion:

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion:

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods?

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.    

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.    

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?

Is this ICR related to the Pandemic Response?

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Common Form ICR: 

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date:

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