Document
Fast Track PRA Submission Short Form
ICR 202606-0970-009 · OMB 0970-0617 · Object 169937800.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Fast Track PRA Submission Short Form |
| Author | OMB |
| Last Modified By | Writer |
| File Modified | 2024-03-05 |
| File Created | 2026-06-17 |
| Conversion State | complete |
Extracted Text
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: Registration Form for Office of Regional Operations Benefits Cliff Convenings
PURPOSE: In 2024, the Office of Regional Operations (ORO) will conduct four convenings with states, territories, and the District of Columbia to educate them on the benefits cliff, share best practices, provide technical assistance, and implement strategies to minimize and eliminate the cliff effects.
To appropriately plan and coordinate these virtual convenings, ORO will ask participants to register and provide the following information: name, title, organization, state, and email address. This information will be used for planning purposes only.
DESCRIPTION OF RESPONDENTS: Participants will be commissioners, leaders, and managers from states, territories, and the District of Columbia who have oversight of their human services or benefits cliff pilot programs.
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: Chad Demetrius Sawyer, Regional Administration, Region 3, Office of Regional Operations, ACF
To assist review, please provide the following information:
BURDEN HOURS
FEDERAL COST: The estimated annual cost to the Federal government is _$2,260.80______
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
Please make sure that all instruments, instructions, and scripts are submitted with the request.