Beneficiary Enrollment Survey - Massachusetts 

Welcome!


Thank you for taking the time to complete this survey. The purpose of this information collection is to help the federal program team understand diaper need in communities across the country. This is a voluntary collection of information. It should take you about 15 minutes to complete this survey. Your responses will be kept private. The information collected will be shared with both federal program staff and a research team, but your responses will be anonymous.

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to help the federal program team understand diaper need in communities across the country. Public reporting burden for this collection of information is estimated to average 10 minutes per respondent, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0642 and the expiration date is 04/30/2028. If you have any comments on this collection of information, please contact Jessica Hale at Jessica.Hale@acf.hhs.gov.