Information Collection

Access and Visitation Survey - States and Jurisdictions

IC 10033 under ICR 202408-0970-002 · OMB 0970-0204.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 - Through Sept 3 Access and Visitation Survey - States and Jurisdictions	Form
Form 1 - Through Sept 3 Access and Visitation Survey - States and Jurisdictions	Form
Access and Visitation Instruction Manual_12.22.23.docx	Instruction
Access and Visitation Instruction Manual_12.22.23.docx	Instruction
Access and Visitation Instruction Manual_8.5.2024 - For use beginning 10.1.24.docx	Instruction
Access and Visitation Instruction Manual_8.5.2024 - For use beginning 10.1.24.docx	Instruction
1 - Through Sept 3 AV Survey - FOR USE UNTIL Oct 2024 Grantee or Subgrantee Collection Instrument 12.20.2023.xls	Form
1 - Through Sept 3 AV Survey - FOR USE UNTIL Oct 2024 Grantee or Subgrantee Collection Instrument 12.20.2023.xls	Form
1 - Oct 2024 AV Survey - FOR USE BEGINNING Oct 2024 State Summary File_08.02.2024 - For use beginning 10.1.24.xlsx	Form
1 - Oct 2024 AV Survey - FOR USE BEGINNING Oct 2024 State Summary File_08.02.2024 - For use beginning 10.1.24.xlsx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 303

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1 - Through Sept 30, 2024	AV Survey - FOR USE UNTIL Oct 2024	Grantee or Subgrantee Collection Instrument 12.20.2023.xls	Yes	Yes	Fillable Printable
Instruction			Access and Visitation Instruction Manual_12.22.23.docx	Yes	Yes	Printable Only
Form	1 - Oct 2024	AV Survey - FOR USE BEGINNING Oct 2024	State Summary File_08.02.2024 - For use beginning 10.1.24.xlsx	Yes	Yes	Fillable Fileable
Instruction			Access and Visitation Instruction Manual_8.5.2024 - For use beginning 10.1.24.docx	Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 53

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	53	53
Annual IC Time Burden (Hours)	848	848
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.