Information Collection

Feedback from CLASS Video Pilot

IC 258669 under ICR 202306-0970-006 · OMB 0970-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Video Recorder Feedback Forms_12-22-22.docx	Other-Survey
Feedback Forms for AdminDirectors-12-22-22.docx	Other-Feedback Form
SSA Template - Formative for ACF Program Support OHS CLASS Video Pilot 12.22.22_clean_submit.docx Supporting Statement A	IC Document

IC Title:

Feedback from CLASS Video Pilot

Agency IC Tracking Number:

IC Status: Unchanged

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-Survey			Video Recorder Feedback Forms_12-22-22.docx		Yes	Yes	Fillable Fileable
Other-Feedback Form			Feedback Forms for AdminDirectors-12-22-22.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: 1,262

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,262	1,262
Annual IC Time Burden (Hours)	122	122
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement A	SSA Template - Formative for ACF Program Support OHS CLASS Video Pilot 12.22.22_clean_submit.docx	02/22/2023

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