Information Collection

Wave 2 Survey instrument

IC 179582 under ICR 200906-0970-005 · OMB 0970-0322.

Documents and Forms

Document Name Document Type
Wave 2 Survey instrument.doc Other-Wave 2 Survey instrument

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Wave 2 Survey instrument	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-Wave 2 Survey instrument			Wave 2 Survey instrument.doc		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,120	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	4,120	-80	4,200
Annual IC Time Burden (Hours)	3,090	318	2,772
Annual IC Cost Burden (Dollars)	0	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.