Information Collection

YTD--Baseline Questionnaire

IC 9741 under ICR 200806-0960-012 · OMB 0960-0687.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0687 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
YTD--Baseline Questionnaire	Form
Baseline Pre-Notification Letter.pdf	Other-Notification Letter
Baseline Questionnaire for Youth Transition Process Demo Baseline Questionnaire.pdf	Form
Baseline Consent Forms.pdf Baseline Consent Forms	IC Document

IC Title:

YTD--Baseline Questionnaire

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	N/A	Baseline Questionnaire for Youth Transition Process Demonstration	Baseline Questionnaire.pdf		No		Printable Only
Other-Notification Letter			Baseline Pre-Notification Letter.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,531

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,531	1,569	962
Annual IC Time Burden (Hours)	1,392	863	529
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Baseline Consent Forms	Baseline Consent Forms.pdf	11/13/2008

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