Information Collection

CJRP- JRFC Pilot Test

IC 263914 under ICR 202311-1121-004 · OMB 1121-0360.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0360 can be found here:

Documents and Forms

Document Name Document Type
1121-0360 AppendixE-JFRC_Instrument.docx Other-
1121-0360 AppendixE-JFRC_Instrument.docx Other-
1121-0360 AppendixD-CJRP_Instrument_Revised.docx Other-
1121-0360 AppendixD-CJRP_Instrument_Revised.docx Other-
AppendixG-IRB_PrivacyCertificate (2).pdf Appendix G Privacy Certificate IC Document
AppendixG-IRB_PrivacyCertificate (2).pdf Appendix G Privacy Certificate IC Document
AppendixF-Confidentiality.pdf Appendix F- Confidentiality IC Document
AppendixF-Confidentiality.pdf Appendix F- Confidentiality IC Document
AppendixC-ExternalConsultants.docx Appendix C- External Consultants IC Document
AppendixC-ExternalConsultants.docx Appendix C- External Consultants IC Document
AppendixB-Contact_Materials-OMB_Revised (1).docx Appendix B IC Document
AppendixB-Contact_Materials-OMB_Revised (1).docx Appendix B IC Document
OMB Memo - CJRP- JRFC Pilot Test-OMB_Revised (1).docx Test Pilot IC Document
OMB Memo - CJRP- JRFC Pilot Test-OMB_Revised (1).docx Test Pilot IC Document
AppendixA-Acts (2).pdf Appendix A- Acts IC Document
AppendixA-Acts (2).pdf Appendix A- Acts IC Document
GEN IC (1121-0360) - CJRP- JRFC Pilot Test (1).docx 1121-0360 Gen IC IC Document
GEN IC (1121-0360) - CJRP- JRFC Pilot Test (1).docx 1121-0360 Gen IC IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CJRP- JRFC Pilot Test	Agency IC Tracking Number:

IC Status: New

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-			1121-0360 AppendixE-JFRC_Instrument.docx		Yes	Yes	Fillable Fileable
Other-			1121-0360 AppendixD-CJRP_Instrument_Revised.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 360	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	360	360
Annual IC Time Burden (Hours)	1,026	1,026
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix G Privacy Certificate	AppendixG-IRB_PrivacyCertificate (2).pdf	12/13/2023
Appendix F- Confidentiality	AppendixF-Confidentiality.pdf	12/13/2023
Appendix C- External Consultants	AppendixC-ExternalConsultants.docx	12/13/2023
Appendix B	AppendixB-Contact_Materials-OMB_Revised (1).docx	12/13/2023
Test Pilot	OMB Memo - CJRP- JRFC Pilot Test-OMB_Revised (1).docx	12/13/2023
Appendix A- Acts	AppendixA-Acts (2).pdf	12/13/2023
1121-0360 Gen IC	GEN IC (1121-0360) - CJRP- JRFC Pilot Test (1).docx	12/13/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.