Evaluation of Older Americans Act Title VI Program Staff-Focus Group

Annual Performance Reporting of the Administration for Community Living’s American Indian, Alaskan Natives and Native Hawaiian Programs

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0059 can be found here:

Documents and Forms

Document Name Document Type
Form 2 Evaluation of Older Americans Act Title VI Program Staff-Focus Group Form and Instruction
2 Title VI Program Staff Focus Moderator Guide F. Title VI Program Staff Focus Group Moderator Guide.docx Form and Instruction
2 Program Staff Focus Group Consent Form Title VI Program Staff Focus Group Consent 2-2.docx Form

Information Collection (IC) Details

IC Title:	Evaluation of Older Americans Act Title VI Program Staff-Focus Group	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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	2	Title VI Program Staff Focus Moderator Guide	F. Title VI Program Staff Focus Group Moderator Guide.docx		No		Printable Only
Form	2	Program Staff Focus Group Consent Form	Title VI Program Staff Focus Group Consent 2-2.docx		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-10	10
Annual IC Time Burden (Hours)	-20	20
Annual IC Cost Burden (Dollars)	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.