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Administration for Native Americans (ANA) Panel Reviewer Profile Questionnaire
Generic Reviewer Recruitment Form
OMB: 0970-0477
IC ID: 257505
OMB.report
HHS/ACF
OMB 0970-0477
ICR 202303-0970-005
IC 257505
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0477 can be found here:
2023-04-25 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
ANA RRM Form 2023_12.21.22.docx
Other-Questionairre
ANA RRM Form 2023_12.21.22.docx
Other-Questionairre
ANA RRM Questionnaire 2023_12.21.22.docx
Reviewer Recruitment GenIC - ANA Panel Reviewer Profile Questionnaire
IC Document
ANA RRM Questionnaire 2023_12.21.22.docx
Reviewer Recruitment GenIC - ANA Panel Reviewer Profile Questionnaire
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Administration for Native Americans (ANA) Panel Reviewer Profile Questionnaire
Agency IC Tracking Number:
ANA
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-Questionairre
ANA RRM Form 2023_12.21.22.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:
300
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
300
0
0
0
0
300
Annual IC Time Burden (Hours)
120
0
0
0
0
120
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Reviewer Recruitment GenIC - ANA Panel Reviewer Profile Questionnaire
ANA RRM Questionnaire 2023_12.21.22.docx
12/21/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.