GenIC ACF Gatherings - NCSACW Convening Registration Information Collection

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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 Convening Registration Information Collection
PURPOSE: The purpose of the survey is to collect information prior to respondent participation in planned convenings. Information will be used for planning purposes. 
DESCRIPTION OF RESPONDENTS: Individuals who participate in convenings through the National Center on Substance Abuse and Child Welfare (NCSACW).  
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 6 total annual Convenings. The time to complete the questions is estimated to average about two minutes.

Instrument Title
Category of Respondent
No. of Respondents
Participation Time
Burden
NCSACW Convening Registration Information Collection
Private Sector
35
4 minutes 
2 hours 
NCSACW Convening Registration Information Collection
State, Local, and Tribal Government
35
4 minutes
2 hours
NCSACW Convening Registration Information Collection
Individuals
35
4 minutes
2 hours
Totals 

105
4 minutes
6 hours 

FEDERAL COST: The estimated annual cost to the Federal government is $1,155. 

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