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National Family Caregiver Support Program Process
The National Family Caregiver Support Program Process Evaluation
OMB: 0985-0038
IC ID: 211930
OMB.report
HHS/ACL
OMB 0985-0038
ICR 201506-0985-001
IC 211930
( )
Documents and Forms
Document Name
Document Type
Form 3
National Family Caregiver Support Program Process
Form and Instruction
3 NFCSP LSP Survey
LSP_survey_2014_0430.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Family Caregiver Support Program Process
Agency IC Tracking Number:
Is this a Common Form?
No
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
Form and Instruction
3
NFCSP LSP Survey
LSP_survey_2014_0430.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:
1,000
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
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
1,000
0
0
0
0
1,000
Annual IC Time Burden (Hours)
330
0
0
0
0
330
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.