Meeting Registration GenIC - Registration Form for ORO Benefits Cliff Convenings

ACFMeetingRegistrationGenICSubmissionForm_508_benefits cliff_03052024.docx

Administration for Children and Families Generic for Information Collections related to Gatherings

Meeting Registration GenIC - Registration Form for ORO Benefits Cliff Convenings

OMB: 0970-0617

Document [docx]
Download: docx | pdf



Request for Approval under the “Administration for Children and Families Generic for Information Collections Related to Gatherings”

(OMB Control Number: 0970-0617)



TITLE OF INFORMATION COLLECTION: Registration Form for Office of Regional Operations Benefits Cliff Convenings


PURPOSE: In 2024, the Office of Regional Operations (ORO) will conduct four convenings with states, territories, and the District of Columbia to educate them on the benefits cliff, share best practices, provide technical assistance, and implement strategies to minimize and eliminate the cliff effects.


To appropriately plan and coordinate these virtual convenings, ORO will ask participants to register and provide the following information: name, title, organization, state, and email address. This information will be used for planning purposes only.


DESCRIPTION OF RESPONDENTS: Participants will be commissioners, leaders, and managers from states, territories, and the District of Columbia who have oversight of their human services or benefits cliff pilot programs.



CERTIFICATION:

I certify the following to be true:

  1. The collection is voluntary.

  2. The collection is low-burden for respondents and low-cost for the Federal Government.

  3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

  4. The information collected is not intended to be disseminated to the public1.

  5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.


Name and affiliation: Chad Demetrius Sawyer, Regional Administration, Region 3, Office of Regional Operations, ACF



To assist review, please provide the following information:



BURDEN HOURS


Instrument Title

Category of Respondent

No. of Respondents

Number of responses

Participation Time

Burden

Registration Form for Office of Regional Operations Benefits Cliff Convenings

State, local, or tribal governments

120

4

5 minutes

40 hours



FEDERAL COST: The estimated annual cost to the Federal government is _$2,260.80______



Administration of the Instrument

  1. How will you collect the information? (Check all that apply)

[X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain



Please make sure that all instruments, instructions, and scripts are submitted with the request.

1 The information collected through this request is primarily for internal review and will not be published. However, for certain activities information submitted by accepted participants, such as research abstracts to be presented in a poster session, may be published on an ACF website or included in a printed or online program for the activity or subsequent publication describing the activity.

2

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleFast Track PRA Submission Short Form
AuthorOMB
File Modified0000-00-00
File Created2024-07-27

© 2024 OMB.report | Privacy Policy