GenIC ACF Gatherings - NCSACW Site Visit Registration Information Collection

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: National Center on Substance Abuse and Child Welfare Site Visit Registration Information Collection

PURPOSE: The purpose of the survey is to collect registration information prior to respondent participation in planned site visits. Information will be used for planning purposes.

DESCRIPTION OF RESPONDENTS: Individuals who are affiliated with Regional Partnership Grant (RPG) and In-Depth Technical Assistance (IDTA) programs through the National Center on Substance Abuse and Child Welfare (NCSACW) who will participate in planned site visits.

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: Surina Amin, Child Welfare Program Specialist

To assist review, please provide the following information:

BURDEN HOURS

The estimated burden includes registration for about 9 total annual Site Visits. The time to complete the questions is estimated to average about four minutes.

Instrument Title	Category of Respondent	No. of Respondents	Participation Time	Burden
NCSACW Site Visit Registration Information Collection	Private Sector	650	4 minutes	43 hours

FEDERAL COST: The estimated annual cost to the Federal government is $1,035.

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

1 The information collected through this request is primarily for internal review and will not be published.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