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Instrument 3: LIA Interview Protocol
Family Level Assessment and State of Home Visiting (FLASH-V) Outreach and Recruitment Study
OMB: 0970-0559
IC ID: 243696
OMB.report
HHS/ACF
OMB 0970-0559
ICR 202009-0970-008
IC 243696
( )
Documents and Forms
Document Name
Document Type
Instrument 3_LIA Interview Protocol.docx
Other-LIA Interview Protocol
Instrument 3_LIA Interview Protocol_REVISED_1.15.21_CLEAN.docx
Other-LIA Interview Protocol
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Instrument 3: LIA Interview Protocol
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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-LIA Interview Protocol
Instrument 3_LIA Interview Protocol_REVISED_1.15.21_CLEAN.docx
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:
120
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
60
0
60
0
0
0
Annual IC Time Burden (Hours)
45
0
45
0
0
0
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.