Information Collection

Compassion Capital Fund Program Evaluation-Baseline and Follow-Up

IC 10151 under ICR 200610-0970-006 · OMB 0970-0293.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0293 can be found here:

Documents and Forms

Document Name Document Type
Form 0 Compassion Capital Fund Program Evaluation-Baseline and Follow-Up Form and Instruction
0 a Baseline survey - CHANGE version per OMB 12-06.doc Form and Instruction
0 a Follow-up Survey - CHANGE version per OMB 12-06 (2).doc Form
0 a Baseline survey - REV 9-06.doc Form and Instruction
0 a Follow-up Survey REV 9-12-06.doc Form and Instruction
0 a OMB Change table baseline survey 8-8-06.doc Form and Instruction
0 a OMB change table follow up survey9-13-06.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Compassion Capital Fund Program Evaluation-Baseline and Follow-Up	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	a	Baseline survey - REV 9-06.doc	No	No	Printable Only
Form and Instruction	a	Follow-up Survey REV 9-12-06.doc	No	No	Fillable Printable
Form and Instruction	a	OMB Change table baseline survey 8-8-06.doc	No	No	Fillable Fileable
Form and Instruction	a	OMB change table follow up survey9-13-06.doc	No	No	Fillable Printable
Form and Instruction	a	Baseline survey - CHANGE version per OMB 12-06.doc	No		Printable Only
Form	a	Follow-up Survey - CHANGE version per OMB 12-06 (2).doc	No		Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,575	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 10 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,575	1,575
Annual IC Time Burden (Hours)	583	583
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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