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9. MUSE Local Program Evaluator Survey 7.9.18 CLEAN
Multi-Site Implementation Evaluation of Tribal Home Visiting
OMB: 0970-0521
IC ID: 232424
OMB.report
HHS/ACF
OMB 0970-0521
ICR 202007-0970-011
IC 232424
( )
Documents and Forms
Document Name
Document Type
9. MUSE Local Program Evaluator Survey FINAL 1.17.19.pdf
Other-Survey
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
9. MUSE Local Program Evaluator Survey 7.9.18 CLEAN
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
Other-Survey
9. MUSE Local Program Evaluator Survey FINAL 1.17.19.pdf
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:
10
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 %
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
10
0
0
0
0
10
Annual IC Time Burden (Hours)
5
0
0
0
0
5
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.