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Title IV-E Tribal-State Agreement Evaluation
Formative Data Collections for ACF Program Support
OMB: 0970-0531
IC ID: 257039
OMB.report
HHS/ACF
OMB 0970-0531
ICR 202212-0970-006
IC 257039
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:
2024-10-04 - No material or nonsubstantive change to a currently approved collection
2024-09-30 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Title_IV-E_Tribal_State_IV-E_Survey 11_18_22.docx
Other-Survey
Title_IV-E_Tribal_State_IV-E_Survey 11_18_22.docx
Other-Survey
SSA Form for Supplemental IV-E Project for Formative - OMB Part 1 11_21_22.docx
SSA Form for Supplemental IV-E Project for Formative
IC Document
SSA Form for Supplemental IV-E Project for Formative - OMB Part 1 11_21_22.docx
SSA Form for Supplemental IV-E Project for Formative
IC Document
SSB Form for Supplemental IV-E Project for Formative - OMB Form 11_18_22_SD.docx
SSB Form for Supplemental IV-E Project for Formative
IC Document
SSB Form for Supplemental IV-E Project for Formative - OMB Form 11_18_22_SD.docx
SSB Form for Supplemental IV-E Project for Formative
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Title IV-E Tribal-State Agreement Evaluation
Agency IC Tracking Number:
CB
IC Status:
Unchanged
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-Survey
Title_IV-E_Tribal_State_IV-E_Survey 11_18_22.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
40
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
40
0
0
0
0
40
Annual IC Time Burden (Hours)
7
0
0
0
0
7
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA Form for Supplemental IV-E Project for Formative
SSA Form for Supplemental IV-E Project for Formative - OMB Part 1 11_21_22.docx
11/21/2022
SSB Form for Supplemental IV-E Project for Formative
SSB Form for Supplemental IV-E Project for Formative - OMB Form 11_18_22_SD.docx
11/21/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.