Information Collection

Listening Session with LGBTQIA+ Individuals and Service Providers Living/Working in Georgia Urban and Rural Communities

IC 269649 under ICR 202502-0970-001 · OMB 0970-0630.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
LGBTQIA+ Listening Session Instrument v1.docx	Other-Listening Session Protocol
LGBTQIA+ Listening Session Instrument v1.docx	Other-Listening Session Protocol
SSA Template - Generic for Engagement Activities_R4_LGBTQIA_ Listening Sessions_7.25.24.docx SSA Engagement GenIC - Listening Session with LGBTQIA+ Individuals and Service Providers Living/Working in Georgia Urban and Rur	IC Document
SSA Template - Generic for Engagement Activities_R4_LGBTQIA_ Listening Sessions_7.25.24.docx SSA Engagement GenIC - Listening Session with LGBTQIA+ Individuals and Service Providers Living/Working in Georgia Urban and Rur	IC Document
R4 Listening Session Consent Form_07.25.24.docx Consent - Listening Session with LGBTQIA+ Individuals and Service Providers Living/Working in Georgia Urban and Rural Communitie	IC Document
R4 Listening Session Consent Form_07.25.24.docx Consent - Listening Session with LGBTQIA+ Individuals and Service Providers Living/Working in Georgia Urban and Rural Communitie	IC Document

IC Title:

Agency IC Tracking Number:

ORO

IC Status: Unchanged

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
Other-Listening Session Protocol					No		Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 72

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	72	72
Annual IC Time Burden (Hours)	108	108
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA Engagement GenIC - Listening Session with LGBTQIA+ Individuals and Service Providers Living/Working in Georgia Urban and Rural Communities		07/26/2024
Consent - Listening Session with LGBTQIA+ Individuals and Service Providers Living/Working in Georgia Urban and Rural Communities		07/26/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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