Information Collection

Pilot Study Instruments

IC 200296 under ICR 201111-3135-001 · OMB 3135-0131.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3135-0131 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3 Pilot Study Instruments	Form and Instruction
3 AABS Pilot - Survey Instruments AABS Pilot - Survey Instruments.pdf	Form and Instruction

IC Title:

Pilot Study Instruments

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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 and Instruction	3	AABS Pilot - Survey Instruments	AABS Pilot - Survey Instruments.pdf		No		Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 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
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.