Information Collection

2024 Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Evaluation Surveys

IC 264349 under ICR 202401-0915-004 · OMB 0915-0212.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 2024 Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Evaluation Surveys	Form
Form 1 Conference Evaluation Survey 2024 Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Evaluation Surveys	Form
1 Conference Evaluation Survey Instrument A_Conference Evaluation Survey.docx	Form
1 Conference Evaluation Survey Instrument A_Conference Evaluation Survey.docx	Form
Fast track memo.ITAC Satisfaction Surveys.docx Original Generic Request	IC Document
Fast track memo.ITAC Satisfaction Surveys.docx Original Generic Request	IC Document

IC Title:

Agency IC Tracking Number:

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
Form	1				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,960

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	1,960	1,960
Annual IC Time Burden (Hours)	102	102
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Original Generic Request		01/09/2024

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

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