Information Collection

Evaluation of Program Rehabilitation and Restitution (PRR)

IC 7662 under ICR 200610-0930-003 · OMB 0930-0248.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Appendices A - E Evaluation of Program Rehabilitation and Restitution (PRR)	Form and Instruction
Appendices A - E Appendices A - E OMB 2006 Appendices A-E.pdf	Form and Instruction
OMB 2006 Appendices F-I.pdf Appendices F - I	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	Appendices A - E	Appendices A - E	OMB 2006 Appendices A-E.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 349

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	503	-286	0	789
Annual IC Time Burden (Hours)	729	-1,125	731	1,123
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendices F - I	OMB 2006 Appendices F-I.pdf	09/29/2006

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