Title IV-E Prevention Services Plan

Plan for Foster Care, Prevention and Permanency—Title IV–E

Documents and Forms

Document Name Document Type
2a - Prevention services plan - State PI 1809.docx Instruction
2a - Prevention services plan - State PI 1809.docx Instruction
2b - Prevention serv plan - Tribal PI 1810.pdf Instruction
2b - Prevention serv plan - Tribal PI 1810.pdf Instruction
2c - Transitional PI_Attachment B_Checklist draft 5.17.19 final1.docx Instruction
2c - Transitional PI_Attachment B_Checklist draft 5.17.19 final1.docx Instruction

Information Collection (IC) Details

IC Title:	Title IV-E Prevention Services Plan	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	2a - Prevention services plan - State PI 1809.docx	Yes	Yes	Fillable Fileable
Instruction	2b - Prevention serv plan - Tribal PI 1810.pdf	Yes	Yes	Fillable Fileable
Instruction	2c - Transitional PI_Attachment B_Checklist draft 5.17.19 final1.docx	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	12	-18	30
Annual IC Time Burden (Hours)	60	-90	150
Annual IC Cost Burden (Dollars)	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.