Baseline and Follow Up Survey

Evaluation of Veterans Homelessness Prevention Demonstration

Documents and Forms

Document Name Document Type
VHPD OMB Part A Appendix B Baseline& Follow-up Surveys.docx Other-Baseline & Follow Up Surveys
VHPD baseline client interview Draft 18 8-22-2012.docx Other-Baseline Client Interview
VHPD follow up client interview 8-22-2012 - Draft 10.docx Other-Follow Up Client Interview

Information Collection (IC) Details

IC Title:	Baseline and Follow Up Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Baseline & Follow Up Surveys	VHPD OMB Part A Appendix B Baseline& Follow-up Surveys.docx	No	Paper Only
Other-Baseline Client Interview	VHPD baseline client interview Draft 18 8-22-2012.docx	No	Paper Only
Other-Follow Up Client Interview	VHPD follow up client interview 8-22-2012 - Draft 10.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: 900	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	900	900
Annual IC Time Burden (Hours)	450	450
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.