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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Mother and Infant Home Visiting Program Evaluation: Kindergarten Follow-Up (MIHOPE-K)
Agency IC Tracking Number:
IC Status:
Unchanged
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-Recruitment Screener
Instrument 1_MIHOPE-K_Pilot_Recruitment Script_5.3.21.docx
Yes
Yes
Fillable Fileable
Other-Virtual Visit
Instrument 2_MIHOPE-K_Pilot_Virtual Visit Specifications_Clean Copy_5.3.21.docx
Yes
Yes
Fillable Fileable
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:
125
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
125
0
0
0
0
125
Annual IC Time Burden (Hours)
219
0
0
0
0
219
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA - MIHOPE-K Pretesting GenIC
Generics SSA - Draft of Cohorts 3 and 4 pretesting generic_5.4.21.docx
05/18/2021
SSB - MIHOPE-K Pretesting GenIC
Generics SSB - Draft of Cohorts 3 and 4 pretesting generic_04.20.21.docx
05/18/2021
Appendix A - MIHOPE-K_Pilot_Caregiver Contact Materials
Appendix A_MIHOPE-K_Pilot_Caregiver Contact Materials_Clean Copy_5.3.21.docx
05/18/2021
NOA - MIHOPE LT Pretesting GenIC_5.17.21
NOA - MIHOPE LT Gen IC_0970-0355_5.17.21.pdf
05/18/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.