Information Collection

Evaluation Of Hew Programs: Services To Victims Of Domestic Violence (a) State Survey (b) Community Survey

IC 116526 under ICR 197912-0990-002 · OMB 0990-0043.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0043 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	EVALUATION OF HEW PROGRAMS: SERVICES TO VICTIMS OF DOMESTIC VIOLENCE (A) STATE SURVEY (B) COMMUNITY SURVEY	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

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
Form	OS-24-79				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,641	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	2,641	2,641
Annual IC Time Burden (Hours)	3,331	3,331
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

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