Information Collection

Enhanced Services for the Hard-to-Employ Demonstration and Evaluation: Rhode Island 36-Month Follow Up Data Collection--Older Child Component

IC 183052 under ICR 200712-0970-004 · OMB 0970-0337.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
OMB HtE RI 36M_App A.2_Youth Survey REV.doc	Other-Older Child Survey
OMB HtE RI 36M_App A.4_Youth Assent Form.doc Youth Assent 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-Older Child Survey			OMB HtE RI 36M_App A.2_Youth Survey REV.doc		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 298

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	298	298
Annual IC Time Burden (Hours)	224	224
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Youth Assent Form	OMB HtE RI 36M_App A.4_Youth Assent Form.doc	11/16/2007

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