Information Collection

Administration for Native Americans (ANA) Panel Reviewer Profile Questionnaire

IC 259807 under ICR 202304-0970-005 · OMB 0970-0477.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0477 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ANA RRM Questionnaire 2023_12.21.22.docx	Other-
ANA RRM Questionnaire 2023_12.21.22.docx	Other-
ACF Reviewer Recruitment Submission Form - 0970-0477_ANA RRM_12.21.22.docx Reviewer Recruitment GenIC - ANA Panel Reviewer Profile Questionnaire	IC Document
ACF Reviewer Recruitment Submission Form - 0970-0477_ANA RRM_12.21.22.docx Reviewer Recruitment GenIC - ANA Panel Reviewer Profile Questionnaire	IC Document
NOA_GenICReviewer_0970-0477_ANA RRN_3.3.23pdf.pdf NOA - ANA Panel Reviewer Profile Questionnaire	IC Document
NOA_GenICReviewer_0970-0477_ANA RRN_3.3.23pdf.pdf NOA - ANA Panel Reviewer Profile Questionnaire	IC Document

IC Title:

Administration for Native Americans (ANA) Panel Reviewer Profile Questionnaire

Agency IC Tracking Number:

ANA

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-			ANA RRM Questionnaire 2023_12.21.22.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: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	120	120
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Reviewer Recruitment GenIC - ANA Panel Reviewer Profile Questionnaire	ACF Reviewer Recruitment Submission Form - 0970-0477_ANA RRM_12.21.22.docx	04/20/2023
NOA - ANA Panel Reviewer Profile Questionnaire	NOA_GenICReviewer_0970-0477_ANA RRN_3.3.23pdf.pdf	04/20/2023

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