Information Collection

Parent or Caregiver "At-Home" Materials Review

IC 264300 under ICR 202409-0925-007 · OMB 0925-0781.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0781 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Parent or Caregiver "At-Home" Materials Review	Form
1 Materials Review Att M - Parent or Caregiver At Home Materials Review - Revised Sept 2024.docx	Form
1 Materials Review Att M - Parent or Caregiver At Home Materials Review - Revised Sept 2024.docx	Form

IC Title:

Parent or Caregiver "At-Home" Materials Review

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Form	1	Materials Review	Att M - Parent or Caregiver At Home Materials Review - Revised Sept 2024.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	15	15
Annual IC Time Burden (Hours)	4	4
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.