Information Collection

Assessment and Evaluation of the Title VI Programs

IC 234844 under ICR 202310-0985-001 · OMB 0985-0059.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Assessment and Evaluation of the Title VI Programs	Form and Instruction
Evaluation Follow-Up Title VI Programs 0059 Evaluation follow up consent and guide priv update .pdf	Form and Instruction
Evaluation Follow-Up Title VI Programs 0059 Evaluation follow up consent and guide priv update .pdf	Form and Instruction
Title VI COVID Supplemental 0059 Title VI COVID Supplemental Funds_Interview Guide.pdf	Form and Instruction
Title VI COVID Supplemental 0059 Title VI COVID Supplemental Funds_Interview Guide.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Form and Instruction	NA	Evaluation Follow-Up Title VI Programs	0059 Evaluation follow up consent and guide priv update .pdf		Yes	Yes	Fillable Fileable
Form and Instruction	NA	Title VI COVID Supplemental	0059 Title VI COVID Supplemental Funds_Interview Guide.pdf		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: 12

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
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	12	0	12
Annual IC Time Burden (Hours)	24	12	12
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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