Fidelity Data (Implementation Quotient Tracker)

Permanency Innovations Initiative (PII) Evaluation - Phase 4

Documents and Forms

Document Name Document Type
Fidelity Data Implementation Quotient Tracker 7-19-12.xlsx Other-Quotient Tracker

Information Collection (IC) Details

IC Title:	Fidelity Data (Implementation Quotient Tracker)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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-Quotient Tracker			Fidelity Data Implementation Quotient Tracker 7-19-12.xlsx		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: 2	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	6	-10	16
Annual IC Time Burden (Hours)	8	-16	24
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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