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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Center for Indigenous Research Collaborations and Learning in Home Visiting (CIRCLE-HV)
Agency IC Tracking Number:
OPRE
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Survey
Instrument 1 Caregiver Survey_v3_clean.docx
Yes
Yes
Fillable Fileable
Other-Survey
Instrument 2 Home Visitor Survey_v3_clean.docx
Yes
Yes
Fillable Fileable
Other-Survey
Instrument 3 Program Leader Survey_v3_clean.docx
Yes
Yes
Fillable Fileable
Other-Interview Protocol
Instrument 4 Caregiver Interview Protocol_v2_clean.docx
Yes
Yes
Printable Only
Other-Interview Protocol
Instrument 5 Home Visitor Interview Protocol_v2_clean.docx
Yes
Yes
Printable Only
Other-Interview Protocol
Instrument 6 Program Leader Interview Protocol_v2_clean.docx
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
211
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
285
0
285
0
0
0
Annual IC Time Burden (Hours)
162
0
162
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA Research GenIC - CIRCLE-HV
Supporting Statement A_Generic Research_CSS_v7_clean-12-22-25.docx
01/08/2026
SSB Research GenIC - CIRCLE-HV
Supporting Statement B_Generic Research_CSS_v7_clean.docx
01/08/2026
Outreach Appendices A-D
Outreach Appendices A - D.docx
01/08/2026
Appendix E: CIRCLE-HV Survey Consent Form
Appendix E- CIRCLE-HV Survey Consent_v3_clean.docx
01/08/2026
Appendix F: CIRCLE-HV Interview Consent Form
Appendix F- CIRCLE-HV Interview Consent_v3_clean.docx
01/08/2026
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.