Information Collection Request

Evaluation of the Community Healthy Marriage Initiative -- Impact Evaluation - Wave 2

ICR 200906-0970-005 · OMB 0970-0322 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Part B.doc Supporting Statement B Uploaded 2009-06-10 Available
Attachment D - Nonresponse bias report.doc Supplementary Document Uploaded 2009-06-10 Available
ATTACHMENT C - Lead Letters.doc Supplementary Document Uploaded 2009-06-10 Available
ATTACHMENT B - Informed consent.doc Supplementary Document Uploaded 2009-06-10 Available
Part A.doc Supporting Statement A Uploaded 2009-06-10 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
179582 Wave 2 Survey instrument Other-Wave 2 Survey instrument Modified
179581 Screening Other-screening Removed

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2010 12 Months From Approved 07/31/2010
4,120 0 13,531
3,090 0 3,332
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Wave 2 Survey instrument
Screening

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,120 13,531 0 -9,411 0 0
Annual Time Burden (Hours) 3,090 3,332 0 -242 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No