Information Collection

Foundational Assessment Survey-States, Courts, and Tribes

IC 224173 under ICR 201610-0970-005 · OMB 0970-0494.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0494 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Foundational Assessment Survey-States, Courts, and Tribes Form and Instruction
1 Foundational Assessment Survey-Center for Courts Foundational Assessment Survey-Center for Courts.docx Form and Instruction
1 Foundational Assessment Survey-Center for States Foundational Assessment Survey-Center for States.docx Form and Instruction
1 Foundational Assessment Survey-Center for Tribes Foundational Assessment Survey-Center for Tribes.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Foundational Assessment Survey-States, Courts, and Tribes	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Foundational Assessment Survey-Center for Courts	Foundational Assessment Survey-Center for Courts.docx	Yes	Yes	Fillable Printable
Form and Instruction	1	Foundational Assessment Survey-Center for States	Foundational Assessment Survey-Center for States.docx	Yes	Yes	Fillable Printable
Form and Instruction	1	Foundational Assessment Survey-Center for Tribes	Foundational Assessment Survey-Center for Tribes.docx	Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 277	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	277	277
Annual IC Time Burden (Hours)	28	28
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.