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Pilot Feedback Form
NHTTAC Consultant and Evaluation Package
OMB: 0970-0519
IC ID: 238432
OMB.report
HHS/ACF
OMB 0970-0519
ICR 202303-0970-009
IC 238432
( )
Documents and Forms
Document Name
Document Type
21 - Pilot Feedback.pdf
Other-
21 - Pilot Feedback.pdf
Other-
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Pilot Feedback Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
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-
21 - Pilot Feedback.pdf
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:
50
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
0
0
-50
0
0
50
Annual IC Time Burden (Hours)
0
0
-8
0
0
8
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.
