View Information Collection Request (ICR) Package
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Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View Generic ICR - OIRA Conclusion
OMB Control No:
0970-0401
ICR Reference No:
201211-0970-002
Status:
Historical Active
Previous ICR Reference No:
201207-0970-001
Agency/Subagency:
HHS/ACF
Agency Tracking No:
Title:
Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/11/2013
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/19/2012
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
04/30/2015
04/30/2015
04/30/2015
Responses
32,090
0
7,090
Time Burden (Hours)
7,062
0
4,062
Cost Burden (Dollars)
0
0
0
Abstract:
This is a generic request to seek feedback from the public on service delivery. This is in accordance with the Administrations's commitment to improving service delivery.
Authorizing Statute(s):
PL:
Pub.L. 110 - 134 125
Name of Law: Head Start Act of 2007
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
23
IC Title
Form No.
Form Name
2013 National Adoption Month Survey
1
2013 National Adoption Month Survey
2013 National Child Abuse Prevention Month Special Initiative Survey
1
2013 National Child Abuse Prevention Month Survey
2015 National Child Abuse Prevention Month Customer Satisfaction Assessment
1
Customer Satisfaction Sruvey
ANA Grantee Conference
1, 1
Conference Evaluation
,
Workshop Evaluation
ANA Grantee Meeting
1
2015 Grantee Meeting Survey
ANA Services Feedback Survey
1
ANA Services Feedback Survey
CWIG Customer Satisfaction at Conferences
1
Satisfaction Assessment
Capacity Building Focus Groups
1
Service Improvement Interview Protocol
Center for States General Assessment for Tailored Services
1
Assessment Protocol
Child Welfare Information Gateway 9-14
1
General Customer Survey
Child Welfare Information Gateway's Customer Satisfaction Assessment
1
Survey
Customer Satisfaction Survey for CWIG - Revision
1
Survey
Father Invovlement Communication Checks
1, 1
Father Screener
,
Fatherhood Discussion Guide
Infant Toddler Associate Degree Course Survey
1
Revised UCinn survey
NFCM Forms
1
NFCM
NRFC
1
Fatherhood Screener
Naational Adoption Month
1
National Adoption Month
Native American Grants Conference
1
Survey
OCS Survey
1, 2
instrument 1
,
instrument 2
OHS T/TA Survey
1
Training and Technical Assistance
Project LAUNCH Multi-Site Evaluation Technical Assistance Grantee Satisfaction Form
Survey Toolkit
1
Survey
Utah Work Success Financial Education
1
Survey
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
32,090
7,090
0
0
25,000
0
Annual Time Burden (Hours)
7,062
4,062
0
0
3,000
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$1,000
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Robert Sargis 2026907275
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
11/19/2012
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