Information Collection

Senior Comparion Program Demonstration Project Impact Evaluation Questionnaires

IC 148448 under ICR 198001-3001-001 · OMB 3001-0020.

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Information Collection (IC) Details

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IC Title:	SENIOR COMPARION PROGRAM DEMONSTRATION PROJECT IMPACT EVALUATION QUESTIONNAIRES	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

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,961	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,961	811	1,150
Annual IC Time Burden (Hours)	1,394	544	850
Annual IC Cost Burden (Dollars)	0	0	0

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