Information Collection

Title IV-E Prevention Services Clearinghouse

IC 263905 under ICR 202401-0970-012 · 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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Title IV-E Prevention Services Clearinghouse	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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 %

	Requested	Previously Approved
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

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.