Information Collection

Parent Survey Questionnaire (Section A – DA)

IC 264324 under ICR 202401-0970-004 · OMB 0970-0627.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0627 can be found here:

Documents and Forms

Document Name Document Type
Instrument 1. Parent Survey Eligibility Confirmation (Section AE Only) and Parent Survey Questionnaire (Section A - DA)_toOPRE_1 Other-Survey - English
Instrument 1. Parent Survey Eligibility Confirmation (Section AE Only) and Parent Survey Questionnaire (Section A - DA)_toOPRE_1 Other-Survey - English
Instrument 1S. Spanish Translation of Instrument 1 Parent Survey Eligibility Confirmation (Section AE Only) and Parent Survey Qu Other-Survey - Spanish
Instrument 1S. Spanish Translation of Instrument 1 Parent Survey Eligibility Confirmation (Section AE Only) and Parent Survey Qu Other-Survey - Spanish

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Parent Survey Questionnaire (Section A â DA)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey - English			Instrument 1. Parent Survey Eligibility Confirmation (Section AE Only) and Parent Survey Questionnaire (Section A - DA)_toOPRE_122923_Clean.docx		Yes	Yes	Fillable Fileable
Other-Survey - Spanish			Instrument 1S. Spanish Translation of Instrument 1 Parent Survey Eligibility Confirmation (Section AE Only) and Parent Survey Questionnaire (Section A - DA)_toOPRE_122923_Clean.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: 1,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	375	375
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.