Information Collection

Title IV-E Prevention Services Clearinghouse

IC 263905 under ICR 202312-0970-006 · OMB 0970-0356.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0356 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1_Consultation Discussion Guide.docx	Other-Consultation Discussion Guide
Instrument 1_Consultation Discussion Guide.docx	Other-Consultation Discussion Guide
Instrument 2_Consultation Feedback Form.docx	Other-Consultation Feedback Form
Instrument 2_Consultation Feedback Form.docx	Other-Consultation Feedback Form
Instrument 3_Program Description Review Request.docx	Other-Program Description Review Req
Instrument 3_Program Description Review Request.docx	Other-Program Description Review Req
Instrument 4_ManualRequest.docx	Other-Manual Request
Instrument 4_ManualRequest.docx	Other-Manual Request
PSC OMB Part A.docx SSA - Title IV-E Prevention Services Clearinghouse	IC Document
PSC OMB Part A.docx SSA - Title IV-E Prevention Services Clearinghouse	IC Document
PSC OMB Part B.docx SSB - Title IV-E Prevention Services Clearinghouse	IC Document
PSC OMB Part B.docx SSB - Title IV-E Prevention Services Clearinghouse	IC Document
NOA_Title IV-E Prev Srvcs Clrnghs GenIC_Formative Generic Research_0970-0356_1.5.22.pdf NOA - Title IV-E Prevention Services Clearinghouse	IC Document
NOA_Title IV-E Prev Srvcs Clrnghs GenIC_Formative Generic Research_0970-0356_1.5.22.pdf NOA - Title IV-E Prevention Services Clearinghouse	IC Document

IC Title:

Title IV-E Prevention Services Clearinghouse

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Consultation Discussion Guide	Instrument 1_Consultation Discussion Guide.docx	Yes	Yes	Printable Only
Other-Consultation Feedback Form	Instrument 2_Consultation Feedback Form.docx	Yes	Yes	Printable Only
Other-Program Description Review Request	Instrument 3_Program Description Review Request.docx	Yes	Yes	Printable Only
Other-Manual Request	Instrument 4_ManualRequest.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: 215

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	71	71
Annual IC Time Burden (Hours)	88	88
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - Title IV-E Prevention Services Clearinghouse	PSC OMB Part A.docx	12/13/2023
SSB - Title IV-E Prevention Services Clearinghouse	PSC OMB Part B.docx	12/13/2023
NOA - Title IV-E Prevention Services Clearinghouse	NOA_Title IV-E Prev Srvcs Clrnghs GenIC_Formative Generic Research_0970-0356_1.5.22.pdf	12/13/2023

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