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Potential PFL-eligible low-income mothers
ASPE Generic Clearance for the Collection of Qualitative Research and Assessment
OMB: 0990-0421
IC ID: 219524
OMB.report
HHS/HHSDM
OMB 0990-0421
ICR 201403-0990-004
IC 219524
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0421 can be found here:
2024-03-27 - No material or nonsubstantive change to a currently approved collection
2024-02-22 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
0990-0421 revisedFocus Groups guide Attach B_Final.docx
Other-focus groups
0990-0421 revisedPhone_Screen_Attach A_Final.docx
Other-survey
0990-0421 revisedPFL DemoQuestion Attach C_Final.docx
Other-questions
0990-0421 revisedSupportingStatementB_PFL_Final.docx
SS part B: Exploring the Relationship between the CA Paid Family Leave Program and the Well-Being of Low-Income Families
IC Document
0990-0421 revised2SupportingStatementA_PFL_Final.docx
Support St. A: Exploring the Relationship between the CA Paid Family Leave Program and the Well-Being of Low-Income Families
IC Document
0990-0421 revised2ASPE Generic - Short Supporting Statement cover sheet_PFL Project _FINAL.docx
Mini SS: Exploring the Relationship between the CA Paid Family Leave Program and the Well-Being of Low-Income Families
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Potential PFL-eligible low-income mothers
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-survey
0990-0421 revisedPhone_Screen_Attach A_Final.docx
No
Printable Only
Other-focus groups
0990-0421 revisedFocus Groups guide Attach B_Final.docx
No
Paper Only
Other-questions
0990-0421 revisedPFL DemoQuestion Attach C_Final.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
80
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
80
0
80
0
0
0
Annual IC Time Burden (Hours)
73
0
73
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SS part B: Exploring the Relationship between the CA Paid Family Leave Program and the Well-Being of Low-Income Families
0990-0421 revisedSupportingStatementB_PFL_Final.docx
01/13/2016
Support St. A: Exploring the Relationship between the CA Paid Family Leave Program and the Well-Being of Low-Income Families
0990-0421 revised2SupportingStatementA_PFL_Final.docx
01/13/2016
Mini SS: Exploring the Relationship between the CA Paid Family Leave Program and the Well-Being of Low-Income Families
0990-0421 revised2ASPE Generic - Short Supporting Statement cover sheet_PFL Project _FINAL.docx
01/13/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.