Information Collection

Program manger/supervisor individual interview - Government

IC 209817 under ICR 201502-0970-009 · OMB 0970-0444.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0444 can be found here:

Documents and Forms

Document Name Document Type
IA Interview Topic Guide.pdf Other-Interview Topic Guide
IB Site Visit Info IB Site Visit Informant Form IB Site Visit Informant Form.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Program manger/supervisor individual interview - Government	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR B (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Interview Topic Guide			IA Interview Topic Guide.pdf		No	No	Paper Only
Form and Instruction	IB Site Visit Informant Form	IB Site Visit Informant Form	IB Site Visit Informant Form.pdf		Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: Records maintained on individuals	FR Citation: 5 FR 43

Number of Respondents: 54	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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	18	-14	32
Annual IC Time Burden (Hours)	18	-14	32
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.