Information Collection

Follow-up Survey-6 months

IC 189109 under ICR 200905-0970-001 · OMB 0970-0383.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0383 can be found here:

Documents and Forms

Document Name Document Type
Form Follow-up Survey Follow-up Survey-6 months Form and Instruction
Follow-up Survey Follow-up Survey TLP Followup Survey 4 2.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Follow-up Survey-6 months	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Follow-up Survey	Follow-up Survey	TLP Followup Survey 4 2.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: 760	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	760	760
Annual IC Time Burden (Hours)	380	380
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.