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Fast Track PRA Submission Short Form

ICR 202606-0970-009 · OMB 0970-0617 · Object 169935300.

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleFast Track PRA Submission Short Form
AuthorOMB
Last Modified ByWriter
File Modified2025-05-21
File Created2026-06-17
Conversion Statecomplete
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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 through the National Center on Substance Abuse and Child Welfare (NCSACW). Information will be used for planning purposes. 

DESCRIPTION OF RESPONDENTS: Individuals who are affiliated with Regional Partnership Grant (RPG) and the NCSACW In-Depth Technical Assistance (IDTA) program

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 five minutes.

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

FEDERAL COST: The estimated annual cost to the Federal government is $1,335. 

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