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Refugee Support Services Youth Mentoring Set-Aside Programs Assessment Guides
Formative Data Collections for ACF Program Support
OMB: 0970-0531
IC ID: 270269
OMB.report
HHS/ACF
OMB 0970-0531
ICR 202410-0970-003
IC 270269
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:
2024-11-12 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
1 - SURVEY_YM Local Provider.docx
Other-Survey
2- QUEST_YM SRC Interview.docx
Other-Interview Protocol
3 - QUEST_YM Client Questionnaire.docx
Other-Questionnaire
4 - QUEST_YM Local Provider Guide.docx
Other-Guide
5 - QUEST_YM Mentor Questionnaire.docx
Other-Questionnaire
SSA_RSS Set Asides Assessment_Formative Prog Support_YM_8.20.2024_updated.docx
SSA - Refugee Support Services Youth Mentoring Set-Aside Programs Assessment Guides
IC Document
Letter_YM Client Invitation and Consent_ENGLISH.docx
Consent - RSS YM Set-Aside Programs Assessment Guides
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Refugee Support Services Youth Mentoring Set-Aside Programs Assessment Guides
Agency IC Tracking Number:
ORR-Ref
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
1 - SURVEY_YM Local Provider.docx
Yes
Yes
Fillable Fileable
Other-Interview Protocol
2- QUEST_YM SRC Interview.docx
Yes
Yes
Printable Only
Other-Questionnaire
3 - QUEST_YM Client Questionnaire.docx
Yes
Yes
Fillable Fileable
Other-Guide
4 - QUEST_YM Local Provider Guide.docx
Yes
Yes
Printable Only
Other-Questionnaire
5 - QUEST_YM Mentor Questionnaire.docx
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:
215
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:
100 %
Requested
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
215
0
0
0
0
215
Annual IC Time Burden (Hours)
132
0
0
0
0
132
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA - Refugee Support Services Youth Mentoring Set-Aside Programs Assessment Guides
SSA_RSS Set Asides Assessment_Formative Prog Support_YM_8.20.2024_updated.docx
08/20/2024
Consent - RSS YM Set-Aside Programs Assessment Guides
Letter_YM Client Invitation and Consent_ENGLISH.docx
08/20/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.