Information Collection

Individual/Households

IC 202644 under ICR 201206-0584-002 · OMB 0584-0582.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Ap D1 - Client Survey.docx Other-Appendix D1 - Client Survey
Ap D2_Client Survey_Spanish.docx Other-Appendix D2 - Client Survey-Sp
Ap F2_Focus Groups with Procedural Denials Guide_Spanish.docx Other-Ap F2_Focus Groups with Proced
Ap F1 - Focus Groups with Procedural Denials Guide-English.docx Other-Ap F1-Focus Groups with Proced
Ap E1 - Client Survey Correspondence-Advance Letter.docx
Appendix E1 - Client Survey Correspondence-Advance Letter (Revised)
IC Document
Ap E2 - Client Survey Correspondence-Client Survey FAQs.docx
Appendix E2 - Client Survey Correspondence-Client Survey FAQs (Revised).docx
IC Document
Ap G1 - Focus Group Advance Letter.docx
Appendix G1 - Focus Group Advance Letter
IC Document
Ap G2 - Focus Group Correspondence-Recruitment Script.docx
Appendix G2 - Focus Group Correspondence-Recruitment Script (Revised)
IC Document
Ap G3 - Focus Group FAQs.docx
Appendix G3 - Focus Group FAQ (Revised)
IC Document
Ap G4_Focus Group Reminder Script.docx
Appendix G4 - Focus Group Reminder Script.
IC Document
Ap G5_Focus Group Participant Consent Form.docx
Appendix G5 - Focus Group Participant Consent Form (Revised).
IC Document
Ap E1.2 - Client Survey Correspondence-SPANISH Advance Letter.docx
Appendix E1.2- Client Survey Correspondence-Advance Letter Spanish
IC Document
Ap E2.2 - Client Survey Correspondence-SPANISH Client Survey FAQs.docx
Appendix E2.2- Client Survey Correspondence-Client Survey FAQs Spanish
IC Document
Ap G1.2 - Focus Group Advance Letter SPANISH.docx
Appendix G1.2-Focus Group Advance Letter Spanish
IC Document
Ap G2.2 - Focus Group Correspondence-Recruitment Script SPANISH.docx
Appendix G2.2- Focus Group Correspondence-Recruitment Script Spanish
IC Document
Ap G3.2 Focus Group FAQs SPANISH.docx
Appendix G3.2-Focus Group FAQ Spanish
IC Document
Ap G4.2_Focus Group Reminder Script SPANISH.docx
Appendix G4.2- Focus Group Reminder Script Spanish
IC Document
Ap G5.2_Focus Group Participant Consent Form-SPANISH.docx
Appendix G5.2- Focus Group Participant Consent Form Spanish
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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
Other-Ap F2_Focus Groups with Procedural Denials Guide_(Revised 062112)_Spanish Ap F2_Focus Groups with Procedural Denials Guide_Spanish.docx No   Paper Only
Other-Ap F1-Focus Groups with Procedural Denials Ap F1 - Focus Groups with Procedural Denials Guide-English.docx No   Paper Only
Other-Appendix D1 - Client Survey Ap D1 - Client Survey.docx No   Paper Only
Other-Appendix D2 - Client Survey-Spanish (Revised) Ap D2_Client Survey_Spanish.docx No   Paper Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,776 0 3,776 0 0 0
Annual IC Time Burden (Hours) 736 0 736 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Appendix E1 - Client Survey Correspondence-Advance Letter (Revised) Ap E1 - Client Survey Correspondence-Advance Letter.docx 08/20/2012
Appendix E2 - Client Survey Correspondence-Client Survey FAQs (Revised).docx Ap E2 - Client Survey Correspondence-Client Survey FAQs.docx 08/20/2012
Appendix G1 - Focus Group Advance Letter Ap G1 - Focus Group Advance Letter.docx 08/20/2012
Appendix G2 - Focus Group Correspondence-Recruitment Script (Revised) Ap G2 - Focus Group Correspondence-Recruitment Script.docx 08/20/2012
Appendix G3 - Focus Group FAQ (Revised) Ap G3 - Focus Group FAQs.docx 08/20/2012
Appendix G4 - Focus Group Reminder Script. Ap G4_Focus Group Reminder Script.docx 08/20/2012
Appendix G5 - Focus Group Participant Consent Form (Revised). Ap G5_Focus Group Participant Consent Form.docx 08/20/2012
Appendix E1.2- Client Survey Correspondence-Advance Letter Spanish Ap E1.2 - Client Survey Correspondence-SPANISH Advance Letter.docx 08/20/2012
Appendix E2.2- Client Survey Correspondence-Client Survey FAQs Spanish Ap E2.2 - Client Survey Correspondence-SPANISH Client Survey FAQs.docx 08/20/2012
Appendix G1.2-Focus Group Advance Letter Spanish Ap G1.2 - Focus Group Advance Letter SPANISH.docx 08/20/2012
Appendix G2.2- Focus Group Correspondence-Recruitment Script Spanish Ap G2.2 - Focus Group Correspondence-Recruitment Script SPANISH.docx 08/20/2012
Appendix G3.2-Focus Group FAQ Spanish Ap G3.2 Focus Group FAQs SPANISH.docx 08/20/2012
Appendix G4.2- Focus Group Reminder Script Spanish Ap G4.2_Focus Group Reminder Script SPANISH.docx 08/20/2012
Appendix G5.2- Focus Group Participant Consent Form Spanish Ap G5.2_Focus Group Participant Consent Form-SPANISH.docx 08/20/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.