Permanency Innovations Initiative

Pre-testing of Evaluation Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0355 can be found here:

Documents and Forms

Document Name Document Type
Kansas Generic Appendix A B Instruments.pdf Other-Kansas #1 Family Assessment Ba
Final Supporting Statement A_Kansas (2).docx Final Supporting Statement A_Kansas (2) IC Document
Final Supporting Statement B_Kansas.docx Final Supporting Statement B_Kansas IC Document

Information Collection (IC) Details

IC Title:	Permanency Innovations Initiative	Agency IC Tracking Number:

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-Kansas #1 Family Assessment Battery and #2 Caseworker interviews			Kansas Generic Appendix A B Instruments.pdf		No		Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	120	0	0	0	0	0
Annual IC Time Burden (Hours)	270	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Final Supporting Statement A_Kansas (2)	Final Supporting Statement A_Kansas (2).docx	09/22/2011
Final Supporting Statement B_Kansas	Final Supporting Statement B_Kansas.docx	09/22/2011

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