Information Collection

PHA Engagement of Homeless Households Follow-up Survey

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

Documents and Forms

Documents and forms in this information collection
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

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	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 %

table that charts list of burden
	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

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.