OMB
.report
Search
Access and Visitation Survey - States and Jurisdictions
Grants to States for Access and Visitation
OMB: 0970-0204
IC ID: 10033
OMB.report
HHS/ACF
OMB 0970-0204
ICR 202403-0970-013
IC 10033
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0204 can be found here:
2024-08-05 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Access and Visitation Survey - States and Jurisdictions
Form
Access and Visitation Instruction Manual_12.22.23.docx
Instruction
Access and Visitation Instruction Manual_12.22.23.docx
Instruction
1 AV Survey
Grantee or Subgrantee Collection Instrument 12.20.2023.xls
Form
1 AV Survey
Grantee or Subgrantee Collection Instrument 12.20.2023.xls
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Access and Visitation Survey - States and Jurisdictions
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
45 CFR 303
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
1
AV Survey
Grantee or Subgrantee Collection Instrument 12.20.2023.xls
Yes
Yes
Fillable Printable
Instruction
Access and Visitation Instruction Manual_12.22.23.docx
Yes
Yes
Printable 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:
53
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
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
53
0
-1
0
0
54
Annual IC Time Burden (Hours)
848
0
-16
0
0
864
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.