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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.