Information Collection

Enhanced Services for the Hard-to-Employ Demonstration and Evaluation: Kansas and Missouri 36-Month Data Collection -- Child Survey

IC 181683 under ICR 200708-0970-004 · OMB 0970-0332.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
OMB HtE KS-MO_App C_36M Direct Asmnt Draft.doc	Other-Child Instrument
HtE KS-MO 36M_App A_Videotape Consent Form FINAL.doc Direct Assessment Consent Form	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? Yes

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
Other-Child Instrument			OMB HtE KS-MO_App C_36M Direct Asmnt Draft.doc		No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 488

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	488	488
Annual IC Time Burden (Hours)	244	244
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Direct Assessment Consent Form	HtE KS-MO 36M_App A_Videotape Consent Form FINAL.doc	11/08/2007

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