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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Self-Regulation Training Approaches and Resources to Improve Staff Capacity for Implementing Healthy Marriage Services for Youth (SARHM)
Agency IC Tracking Number:
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-Questionnaire
Instrument 1_Educator questionnaire.2.docx
Yes
Yes
Fillable Fileable
Other-Interview
Instrument 2_Interview protocol.2.docx
No
Paper Only
Other-Session Assessment
Instrument 3_Session assessment form.2.docx
Yes
Yes
Fillable Fileable
Other-Observation Tool
Instrument 4_Observation tool.2.docx
Yes
Yes
Fillable Fileable
Other-Questionnaire
Instrument 5_Youth questionnaire.2.docx
Yes
Yes
Fillable Fileable
Other-Focus Group Protocol
Instrument 6_Youth focus group protocol.3.clean.docx
No
Paper 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:
197
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
116
0
116
0
0
0
Annual IC Time Burden (Hours)
397
0
397
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SARHM Supporting Statement A
SARHM OMB 2 SSA_070218_revised.2_clean.docx
07/16/2018
SARHM Supporting Statement B
SARHM OMB 2 SSB_070218_clean.docx
07/16/2018
Attachment A - SARHM Legislative Authority
Attachment A_SARHM_Legislative authority.pdf
06/12/2018
Attaachment B_Mathematica Confidentiality Pledge
Attaachment B_SARHM Mathematica Confidentiality Pledge.pdf
06/12/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.