Community Injects Related to Local Environmental Justice and Climate Change Impacts

Formative Data Collections for ACF Program Support

Documents and Forms

Document Name Document Type
IC 1 Individual Stakeholder Interviews_ACF_CLEAN.docx Other-Instrument 1: Interview Script
IC 2 Community Focus Groups_ACF_CLEAN.docx Other-Instrument 2: Focus Group Scri
IC 3 Community Focus Groups + Individual Interviews_OASH_CLEAN.docx Other-Instrument 3: Group Interview
IC 4 Community Representative Interview Request Email_CLEAN.docx Other-Instrument 4: Outreach Email
IC 5 Focus Group Invitation Email_CLEAN.docx Other-Instrument 5: Invitation Email
IC 7 Federal Summit Focus Group_fnl.docx Other-Instrument 7: Federal Summit F
SSA_Amended_ACF Response_06122023_cln.docx Supporting Statement A - OSHEPR Climate Change GenIC.docx IC Document
Change Request - OSHEPR Climate Change GenIC.docx Change Request - Community Injects Related to Local Environmental Justice and Climate Change Impacts - Add Focus Group #7 IC Document

Information Collection (IC) Details

IC Title:	Community Injects Related to Local Environmental Justice and Climate Change Impacts	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Instrument 1: Interview Script	IC 1 Individual Stakeholder Interviews_ACF_CLEAN.docx	Yes	Yes	Fillable Fileable
Other-Instrument 2: Focus Group Script	IC 2 Community Focus Groups_ACF_CLEAN.docx	Yes	Yes	Fillable Fileable
Other-Instrument 3: Group Interview Scripts	IC 3 Community Focus Groups + Individual Interviews_OASH_CLEAN.docx	Yes	Yes	Fillable Fileable
Other-Instrument 4: Outreach Email	IC 4 Community Representative Interview Request Email_CLEAN.docx	Yes	Yes	Fillable Fileable
Other-Instrument 5: Invitation Email	IC 5 Focus Group Invitation Email_CLEAN.docx	Yes	Yes	Fillable Fileable
Other-Instrument 7: Federal Summit Focus Group	IC 7 Federal Summit Focus Group_fnl.docx	Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 881	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	Previously Approved
Annual Number of Responses for this IC	881	881
Annual IC Time Burden (Hours)	1,076	1,076
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A - OSHEPR Climate Change GenIC.docx	SSA_Amended_ACF Response_06122023_cln.docx	06/13/2023
Change Request - Community Injects Related to Local Environmental Justice and Climate Change Impacts - Add Focus Group #7	Change Request - OSHEPR Climate Change GenIC.docx	06/13/2023

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