Information Collection Request

Family Self-Sufficiency Program Evaluation

ICR 201302-2528-001 · OMB 2528-0296 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
FSS Evaluation Form New Available
FSS EVALUATION OMB PACKET PART A - APPENDIX INFORMED CONSENT FORM Revised 3-15-2013.doc Supplementary Document Uploaded 2013-04-18 Available
2528-026-30Day.doc Supplementary Document Uploaded 2013-03-08 Repair queued
MDRC_FSS - SUPPORTING STATEMENT PART B final 7-18-2013.docx Supporting Statement B Uploaded 2013-07-18 Repair queued
MDRC_FSS PRA Supporting Statement _A revised final 7-18-2013.doc Supporting Statement A Uploaded 2013-07-18 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
205698 FSS Evaluation Form New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2016 36 Months From Approved
3,000 0 0
9,378 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
FSS Evaluation N/A, N/A, N/A, N/A Informed Consent Form ,   Baseline Information Form

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,000 0 0 3,000 0 0
Annual Time Burden (Hours) 9,378 0 0 9,378 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No