Maternal, Infant, and Early Childhood Home Visiting (MIECHV) AGM 2019 – Peer Sharing Feedback Survey

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Document Name Document Type
Final - Peer Sharing Session Planning Feedback Form_rev_8.31.18.docx Other-Feedback Form
Fast Track Generic - Submission Template 2019 AGM Peer Sharing Session Survey_CLEAN.doc Fast Track Generic - Submission Template 2019 AGM Peer Sharing Session Survey_CLEAN IC Document

Information Collection (IC) Details

IC Title:	Maternal, Infant, and Early Childhood Home Visiting (MIECHV) AGM 2019 – Peer Sharing Feedback Survey	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-Feedback Form			Final - Peer Sharing Session Planning Feedback Form_rev_8.31.18.docx		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 350	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	350	350
Annual IC Time Burden (Hours)	29	29
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Generic - Submission Template 2019 AGM Peer Sharing Session Survey_CLEAN	Fast Track Generic - Submission Template 2019 AGM Peer Sharing Session Survey_CLEAN.doc	10/18/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.