Information Collection

Impact of Housing and Services Inteventions for Homeless Families

IC 191672 under ICR 201110-2528-002 · OMB 2528-0259.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2528-0259 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Consent Form.docx	Other-Consent Form
Tracking Instrument.docx	Other-Tracking Survey Instrument
ProgramInterview Guide.docx	Other-ProgramInterview
Baseline Justificationi.pdf	Other-Item By Item Baseline Justific
Tracking Instrument Item by Item.pdf	Other-Item by Item Justification Tra
Homeless Families Baseline Pre-test Summary.pdf	Other-Pre-Test Summary
Homeless Families Baseline Interview.docx	Other-Homeless Families Baseline Int
Confidentiality Certifications.pdf Confidentiality Certifications	IC Document

IC Title:

Impact of Housing and Services Inteventions for Homeless Families

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Consent Form	Consent Form.docx	No	Paper Only
Other-Tracking Survey Instrument	Tracking Instrument.docx	No	Paper Only
Other-ProgramInterview	ProgramInterview Guide.docx	No	Paper Only
Other-Item By Item Baseline Justification	Baseline Justificationi.pdf	No	Paper Only
Other-Item by Item Justification Tracking	Tracking Instrument Item by Item.pdf	No	Paper Only
Other-Pre-Test Summary	Homeless Families Baseline Pre-test Summary.pdf	No	Paper Only
Other-Homeless Families Baseline Interview	Homeless Families Baseline Interview.docx	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-3,300	3,300
Annual IC Time Burden (Hours)	-3,900	3,900
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Confidentiality Certifications	Confidentiality Certifications.pdf	04/26/2010

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