OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Subsidized and Transitional Employment Demonstration (STED) and Enhanced Transitional Jobs Demonstration (ETJD)

ICR 201506-0970-017 · OMB 0970-0413 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
App Z Staff Script - Talking with Clients about the Paycheck Plus Study Final 6-26-15.docx Supplementary Document Uploaded 2015-06-29 Available
Appendix W3 PP Atlanta IRS Consent to Use Final 6-26-15.docx Supplementary Document Uploaded 2015-06-29 Repair queued
Appendix W2 PP Atlanta IRS Consent to Disclose Final 06-26-15.docx Supplementary Document Uploaded 2015-06-29 Available
Appendix W1 Paycheck_Plus_ICF_Atlanta_Final 6-26-15.docx Supplementary Document Uploaded 2015-06-29 Available
Appendix T STED_ETJD 30 Month Overview.docx Supplementary Document Uploaded 2014-05-06 Available
STED-ETJD Supporting Statement Part B Final 6-26-15.docx Supporting Statement B Uploaded 2015-06-29 Available
STED Young Adult to Adult Survey Comparison May 2013.docx Supplementary Document Uploaded 2013-05-13 Repair queued
Appendix_B.1_Informed Consent Revised May 2013 Final.docx Supplementary Document Uploaded 2013-05-13 Repair queued
Appendix_J_Interview Guides_26APR12.doc Supplementary Document Uploaded 2012-05-03 Repair queued
STED-ETJD Supporting Statement Part A Final 6-26-15.docx Supporting Statement A Uploaded 2015-06-30 Available
IC Document Collections
IC IDCollectionTypeStatusForm
217255 Appendix Y - Participant baseline information form (Paycheck Plus) Other-Survey New
217254 Appendix X - Contact Information Form for Paycheck Plus site Other-Contact Info New
211534 Appendix U Participant 30-month survey Other-Survey Modified
207067 Participant 12-month survey (Young Adult sites) Other-Survey Unchanged
207066 Participant 6-month survey (Young Adult sites) Other-Survey Unchanged
202240 Program Staff Time-Use Worksheet Other-Staff-Use Worksheet Unchanged
202239 Referral Partner Interview Guides Other-Referral Partners Interview Guides Unchanged
202238 Employer Interview Guides Other-Employer Interview Guides Unchanged
202237 Program Staff Cost Data Collection Protocol Other-Protocol Unchanged
202236 Program Staff Interview Guides Other-Program Staff Interview Guides Unchanged
202235 Employer Implementation Questionnaire Other-Employer Implementation Questionnaire Unchanged
202234 Worksite Supervisor Implementation Questionnaire Other-Worksite Supervisor Implementation Questionnaire Unchanged
202233 Program Staff Implementation Questionnaire Other-Program Staff Implementation Questionnaire Unchanged
202232 Participant Focus Group Discussion Guide Other-Focus Group Guide Unchanged
202231 Participant Implementation Questionnaire Other-Questionnaire Unchanged
202230 Participant 12-month survey (Adult sites) Other-12 Month Follow-Up Unchanged
202229 Participant 6-month survey (Adult sites) Other-6-month survey Unchanged
202228 Participant ETJD tracking letters Other-Tracking Letters Unchanged
202227 Participant STED tracking letters Other-Tracking Letters Unchanged
202226 Participant Baseline Information Form Other-BIF Modified
202225 Participant Contact Information Form Other-Contact Info Form Modified
ICR Details
0970-0413 201506-0970-017
Historical Active 201405-0970-001
HHS/ACF 19600
Subsidized and Transitional Employment Demonstration (STED) and Enhanced Transitional Jobs Demonstration (ETJD)
Revision of a currently approved collection   No
Regular
Approved without change 09/30/2015
Retrieve Notice of Action (NOA) 07/09/2015
  Inventory as of this Action Requested Previously Approved
09/30/2017 36 Months From Approved 09/30/2017
27,009 0 22,475
7,681 0 7,006
0 0 0
This is a revision to the Subsidized and Transitional Employment Demonstration (STED) and Enhanced Transitional Jobs Demonstration (ETJD) information collection. This request includes a contact information form and a baseline form to be administered to study participants in a new STED site. As discussed below, these data collected for the new site will provide important demographic information about the study sample, help to ensure the comparability of the program and control groups, and allow for an analysis of program effects for selected subgroups.
PL: Pub.L. 74 - 271 413 Name of Law: Social Security Act; Research, Evaluations and National Studies
  
None
Not associated with rulemaking
  80 FR 13385 03/13/2015
80 FR 38208 07/02/2015
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 27,009 22,475 0 4,534 0 0
Annual Time Burden (Hours) 7,681 7,006 0 675 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This amendment includes additional data collection efforts, which include the contact information form and baseline form for the new STED site. We have also revised the number of respondents to two previously approved information collections, based on the status of the project.
$8,039,366
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Molly Buck 202 205-4724 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/09/2015