Information Collection

P&A: Interview with Clients

IC 189884 under ICR 201012-0970-004 · OMB 0970-0372.

Documents and Forms

Document Name Document Type
Form 12 P&A: Interview with Clients Form
12 P&A: Interview with Clients PA CLIENT INTERVIEW.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	P&A: Interview with Clients	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
Form	12	P&A: Interview with Clients	PA CLIENT INTERVIEW.doc		Yes	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	75	75
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.