Information Collection Request

Healthy Marriage and Responsible Fatherhood Performance Measures and Additional Data Collection

ICR 202402-0970-008 · OMB 0970-0566 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form RF RF QPR Form and Instruction Modified Available
Form HM HM QPR Form and Instruction Modified Available
Form HM 6: Quarterly Performance Report (QPR) Form and Instruction Modified Repair queued
Form RF RF PPR Form and Instruction Modified Available
Form HM HM PPR Form and Instruction Modified Available
Form HM 5: Semi-annual Performance Progress Report (PPR) Form and Instruction Modified Repair queued
HMRF_OMB_0970-0566_revision_AppC_BurdenAssumptions_02022024_clean.docx Supplementary Document Uploaded 2024-02-14 Repair queued
HMRF_OMB_0970-0566_revision_App_B_IRB_Exemption.pdf Supplementary Document Uploaded 2024-02-14 Repair queued
HMRF_OMB_0970-0566_revision_App_A_LegislativeAuthority.pdf Supplementary Document Uploaded 2024-02-14 Repair queued
HMRF_OMB_0970-0566_revision_Part_B_rev_02022024_clean.docx Supporting Statement B Uploaded 2024-02-14 Repair queued
HMRF_OMB_0970-0566_revision_Part_A_02022024_clean.docx Supporting Statement A Uploaded 2024-02-14 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
246012 7: Continuous Quality Improvement (CQI) Plan Other-Template Modified
246011 6: Quarterly Performance Report (QPR) Form and Instruction ModifiedRF QPR
246011 6: Quarterly Performance Report (QPR) Form and Instruction ModifiedHM QPR
246011 6: Quarterly Performance Report (QPR) Form and Instruction Modified
246010 5: Semi-annual Performance Progress Report (PPR) Form and Instruction ModifiedRF PPR
246010 5: Semi-annual Performance Progress Report (PPR) Form and Instruction ModifiedHM PPR
246010 5: Semi-annual Performance Progress Report (PPR) Form and Instruction Modified
246008 4: Entrance and Exit Surveys - Program staff (entrance and exit on paper) Other-HM Adult Entrance Survey Modified
246007 4: Entrance and Exit Surveys - Program clients (exit) Other-HM Adult Exit Survey Modified
246006 4: Entrance and Exit Surveys - Program clients (entrance) Other-HM Adult Entrance Survey Modified
246005 3: Service Delivery Data Other-Reporting System Modified
246004 2: Program Operations Other-Survey Modified
246003 1: Applicant Characteristics - Program Staff Other-Survey Modified
246002 1: Applicant Characteristics - Program Applicants Other-Survey Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2027 36 Months From Approved 04/30/2024
251,536 0 447,093
78,263 0 140,177
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 251,536 447,093 0 -195,557 0 0
Annual Time Burden (Hours) 78,263 140,177 0 -61,914 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No