Evaluation of the Improving Child Welfare Outcome through Systems of Care Grant Program - Organizational Structure Form for Non-Case Study Sites

Improving Child Welfare Outcomes through Systems of Care

Documents and Forms

Document Name Document Type
Appendix N IC16 - Organizational Structure Form for Non-Case Study Sites.doc Other-survey

Information Collection (IC) Details

IC Title:	Evaluation of the Improving Child Welfare Outcome through Systems of Care Grant Program - Organizational Structure Form for Non-Case Study Sites	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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			Appendix N IC16 - Organizational Structure Form for Non-Case Study Sites.doc		No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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