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8 & 9 - Baseline surveys
Building Bridges and Bonds (B3)
OMB: 0970-0485
IC ID: 220979
OMB.report
HHS/ACF
OMB 0970-0485
ICR 201710-0970-002
IC 220979
( )
Documents and Forms
Document Name
Document Type
9 - Baseline Survey for Sites Testing Employment Intervention.docx
Other-Baseline Survey
8 - Baseline Survey for Sites Testing Parenting Intervention Revised 9-16-16_clean.docx
Other-Survey
9 - Baseline Survey for Sites Testing Employment Intervention - screen shots.docx
Baseline survey screen shots
IC Document
8 - Baseline Survey for Sites Testing Parenting Intervention Spanish 9-16-16.docx
Baseline survey Parent Intervention - Spanish Version
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
8 & 9 - Baseline surveys
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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-Baseline Survey
9 - Baseline Survey for Sites Testing Employment Intervention.docx
Yes
Yes
Fillable Fileable
Other-Survey
8 - Baseline Survey for Sites Testing Parenting Intervention Revised 9-16-16_clean.docx
Yes
Yes
Fillable Fileable
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:
947
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
947
0
0
0
0
947
Annual IC Time Burden (Hours)
608
0
0
0
0
608
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Baseline survey screen shots
9 - Baseline Survey for Sites Testing Employment Intervention - screen shots.docx
09/08/2016
Baseline survey Parent Intervention - Spanish Version
8 - Baseline Survey for Sites Testing Parenting Intervention Spanish 9-16-16.docx
09/30/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.