Healthy Marriage and Responsible Fatherhood Grantee Data Collection Plan Template (BUILD)

Formative Data Collections for ACF Program Support

Documents and Forms

Document Name Document Type
BUILD_DataCollectionPlanTemplate_11202020_toOPRE_120220.docx Other-template
HMRF Grantee DataCollectionPlan_OMB_SSA_12092020_REV_KP 121420_clean_final.docx SSA - Build GenIC Prog Supp IC Document
NOA_BUILD Template_12.17.2020.pdf NOA - BUILD GenIC IC Document

Information Collection (IC) Details

IC Title:	Healthy Marriage and Responsible Fatherhood Grantee Data Collection Plan Template (BUILD)	Agency IC Tracking Number:

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-template			BUILD_DataCollectionPlanTemplate_11202020_toOPRE_120220.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: 113	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 %

	Requested	Previously Approved
Annual Number of Responses for this IC	113	113
Annual IC Time Burden (Hours)	678	678
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA - Build GenIC Prog Supp	HMRF Grantee DataCollectionPlan_OMB_SSA_12092020_REV_KP 121420_clean_final.docx	07/08/2022
NOA - BUILD GenIC	NOA_BUILD Template_12.17.2020.pdf	07/08/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.