Information Collection

Ciap Survey Instrument: Physical Needs Assessment 24 Cfr 868.18

IC 145899 under ICR 198312-2577-008 · OMB 2577-0047.

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Information Collection (IC) Details

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IC Title:	CIAP SURVEY INSTRUMENT: PHYSICAL NEEDS ASSESSMENT 24 CFR 868.18	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

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: 400	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	9,600	9,600
Annual IC Cost Burden (Dollars)	0	0

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