Information Collection

Listening Session with Fathers and Families Living in Rural Pennsylvania, and the Outskirts of Urban and Suburban Communities

IC 266666 under ICR 202401-0970-015 · OMB 0970-0630.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0630 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Facilitation Questions Draft Doc_04082024.docx	Other-Semi-structured protocols
Facilitation Questions Draft Doc_04172024.docx	Other-Semi-structured protocols
SSA Template - Generic for Engagement Activities_R3 Rural Listening Sessions_04082024_v2.docx SSA - Engagement Activities GenIC: Listening Session with Fathers and Families Living in Rural Pennsylvania, and the Outskirts o	IC Document
Listening Session Consent Form_04082024.docx Appendix A – Listening Session Consent Form	IC Document
Listening Session Consent Form_04172024.docx Appendix A - Listening Session Consent Form rev	IC Document
SSA Template - Generic for Engagement Activities_R3 Rural Listening Sessions_04172024.docx SSA - Engagement Activities GenIC: Listening Session with Fathers and Families Living in Rural Pennsylvania and the Outskirts of	IC Document

IC Title:

Listening Session with Fathers and Families Living in Rural Pennsylvania, and the Outskirts of Urban and Suburban Communities

Agency IC Tracking Number:

ORO

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-Semi-structured protocols			Facilitation Questions Draft Doc_04082024.docx		No		Printable Only
Other-Semi-structured protocols			Facilitation Questions Draft Doc_04172024.docx		No		Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 72

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	72	72
Annual IC Time Burden (Hours)	109	109
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - Engagement Activities GenIC: Listening Session with Fathers and Families Living in Rural Pennsylvania, and the Outskirts of Urban and Suburban Communities	SSA Template - Generic for Engagement Activities_R3 Rural Listening Sessions_04082024_v2.docx	04/08/2024
Appendix A â Listening Session Consent Form	Listening Session Consent Form_04082024.docx	04/08/2024
Appendix A - Listening Session Consent Form rev	Listening Session Consent Form_04172024.docx	04/17/2024
SSA - Engagement Activities GenIC: Listening Session with Fathers and Families Living in Rural Pennsylvania and the Outskirts of Urban and Suburban Communities rev	SSA Template - Generic for Engagement Activities_R3 Rural Listening Sessions_04172024.docx	04/17/2024

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