Information Collection

Social Network Analysis of a Service System for Transition Aged Youth

IC 45603 under ICR 200610-0930-002 · OMB 0930-0283.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Instrument Social Network Analysis of a Service System for Transition Aged Youth	Form and Instruction
Instrument Instrument Appendix D.doc	Form and Instruction
Appendix B.pdf Consent Letter	IC Document
Appendix B_1.pdf Consent Letter	IC Document
Appendix B_2.pdf Consent Letter	IC Document
Appendix C_1.pdf IRB - U of MA	IC Document
Appendix C_2.pdf IRB - Portland St U	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Instrument	Instrument	Appendix D.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 110

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	110	110
Annual IC Time Burden (Hours)	138	138
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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