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Evaluation of Older Americans Act Title VI Programs - Caregiver Focus Group
Evaluation of Older Americans Act Title VI Programs
OMB: 0985-0059
IC ID: 227562
OMB.report
HHS/ACL
OMB 0985-0059
ICR 201707-0985-002
IC 227562
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0059 can be found here:
2023-10-31 - Revision of a currently approved collection
2020-08-19 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 6
Evaluation of Older Americans Act Title VI Programs - Caregiver Focus Group
Form and Instruction
6 Title VI Caregiver Focus Group
Title VI Tribal Caregiver Focus Group Moderator Guide.docx
Form and Instruction
6 Tribal Caregiver Group Consent Form
Title VI Tribal Caregiver Focus Group Consent-2-2.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Evaluation of Older Americans Act Title VI Programs - Caregiver Focus Group
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
Form and Instruction
6
Title VI Caregiver Focus Group
Title VI Tribal Caregiver Focus Group Moderator Guide.docx
No
Printable Only
Form
6
Tribal Caregiver Group Consent Form
Title VI Tribal Caregiver Focus Group Consent-2-2.docx
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
87
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 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
87
0
87
0
0
0
Annual IC Time Burden (Hours)
174
0
174
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
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.