Information Collection

PHA Engagement of Homeless Households Follow-up Survey

IC 203643 under ICR 201208-2528-002 · OMB 2528-0291.

Documents and Forms

Document Name Document Type
Revised Appendix A_Follow-Up Survey_8_6_12.pdf Other-Survey
Final Appendix A_Follow-Up Survey_1_11.docx Other-Survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	PHA Engagement of Homeless Households 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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			Revised Appendix A_Follow-Up Survey_8_6_12.pdf		Yes	Yes	Fillable Fileable
Other-Survey			Final Appendix A_Follow-Up Survey_1_11.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 125	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	125	125
Annual IC Time Burden (Hours)	125	125
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.