Information Collection

Additional On-Site Data Collection for HCV Administrative Study

IC 200513 under ICR 201112-2528-003 · OMB 2528-0283.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
HCV Admin Fee_OMB Revised Draft_Appendix B_12-5_11_for HUD review.docx	Other-Telephone Script
HCV Admin Fee_OMB Revised Draft_Appendix C_12-5_11_for HUD review.docx	Other-Interview Guide
HCV Admin Fee_OMB Revised Draft_Appendix B_3-21-12.docx	Other-Telephone Script
HCV Admin Fee_OMB Revised Draft_Appendix C_3-21-12.docx	Other-Interview Guide
HCV Admin Fee_OMB Revised Draft_Appendix C_3-21-12 (5).docx	Other-Interview Guide
HCV Admin Fee_OMB Revised Draft_Appendix B_3-26-12.docx	Other-Telephone Script
HCV Admin Fee_OMB Revised Draft_Appendix C_3-26-12.docx	Other-Interview Guide

IC Title:

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	Instrument File	Available Electronically?	Electronic Capability
Other-Telephone Script	HCV Admin Fee_OMB Revised Draft_Appendix B_12-5_11_for HUD review.docx	No	Paper Only
Other-Interview Guide	HCV Admin Fee_OMB Revised Draft_Appendix C_12-5_11_for HUD review.docx	No	Paper Only
Other-Telephone Script	HCV Admin Fee_OMB Revised Draft_Appendix B_3-21-12.docx	No	Paper Only
Other-Interview Guide	HCV Admin Fee_OMB Revised Draft_Appendix C_3-21-12.docx	No	Paper Only
Other-Interview Guide	HCV Admin Fee_OMB Revised Draft_Appendix C_3-21-12 (5).docx	No	Paper Only
Other-Telephone Script	HCV Admin Fee_OMB Revised Draft_Appendix B_3-26-12.docx	No	Paper Only
Other-Interview Guide	HCV Admin Fee_OMB Revised Draft_Appendix C_3-26-12.docx	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 225

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	225	225
Annual IC Time Burden (Hours)	1,260	1,260
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.