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Federal forms, ICRs, and supporting documents

Information Collection

Consent Form For Interviews - Los Angeles Site

IC 205134 under ICR 201212-0970-004 · OMB 0970-0434.

Documents and Forms
Document Name
Document Type
Other-Consent
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Consent Form For Interviews - Los Angeles Site
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Consent Appendix A-4 - Consent Form For Interviews - Los Angeles Site.docx Yes Yes Fillable Fileable

Community and Social Services Social Services

 

36 0
   
Individuals or Households
 
   0 %

  Approved 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 36 0 36 0 0 0
Annual IC Time Burden (Hours) 7 0 7 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Appendix A-4S - Consent Form For Interviews (Spanish) - Los Angeles Site Appendix A-4S - Consent Form For Interviews (Spanish) - Los Angeles Site.docx 12/11/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.