Information Collection

Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center (ITAC) Satisfaction Surveys

IC 258285 under ICR 202308-0915-005 · OMB 0915-0212.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center (ITAC) Satisfaction Surveys	Form
1 Annual Awardee Survey Instrument A_Annual Awardee Survey.docx	Form
1 Annual Awardee Survey Instrument A_Annual Awardee Survey.docx	Form
2 Post Webinar Survey Instrument B_Post Webinar Survey.docx	Form
2 Post Webinar Survey Instrument B_Post Webinar Survey.docx	Form
3 Post Learning Collaborative Survey Instrument C_Post Learning Collaborative Survey.docx	Form
3 Post Learning Collaborative Survey Instrument C_Post Learning Collaborative Survey.docx	Form
Fast track memo.ITAC Satisfaction Surveys.docx Fast Track Memo	IC Document
Fast track memo.ITAC Satisfaction Surveys.docx Fast Track Memo	IC Document

IC Title:

Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center (ITAC) Satisfaction Surveys

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Annual Awardee Survey	Instrument A_Annual Awardee Survey.docx	Yes	Yes	Fillable Fileable
Form	2	Post Webinar Survey	Instrument B_Post Webinar Survey.docx	Yes	Yes	Fillable Fileable
Form	3	Post Learning Collaborative Survey	Instrument C_Post Learning Collaborative Survey.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 665

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	665	665
Annual IC Time Burden (Hours)	70	70
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Memo	Fast track memo.ITAC Satisfaction Surveys.docx	02/03/2023

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