Information Collection

AHS Age Restricted Living Screening Operation

IC 194341 under ICR 201109-0607-001 · OMB 0607-0809.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0809 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form AHS-101AR AHS Age Restricted Living Screening Operation	Form
Attachment 2.docx	Other-Confidentiality Notice
AHS-101AR AHS Age Restricted Living Screener Questionnaire Attachment 1.docx	Form
AHS Age Restricted Screener OMB Request.docx AHS Age Restricted Living Screening Plan	IC Document

IC Title:

AHS Age Restricted Living Screening Operation

Agency IC Tracking Number:

IC Status: Unchanged

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	AHS-101AR	AHS Age Restricted Living Screener Questionnaire	Attachment 1.docx		No		Paper Only
Other-Confidentiality Notice			Attachment 2.docx		No		Paper Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 599

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	599	599
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
AHS Age Restricted Living Screening Plan	AHS Age Restricted Screener OMB Request.docx	08/20/2010

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