Combined Survey

Evaluation of the Reintegration of Ex-OffendersAdult Program (RExO)

Documents and Forms

Document Name Document Type
Hybrid Survey August 2013.doc Other-Survey

Information Collection (IC) Details

IC Title:	Combined 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			Hybrid Survey August 2013.doc		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: DOL/ETA 15, published April 8, 2002	FR Citation: 67 FR 16898

Number of Respondents: 760	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	760	760
Annual IC Time Burden (Hours)	570	570
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.