6 Month Followup

Cross-Site Evaluation for the Benefit of Homeless Individuals (GBHI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0320 can be found here:

Documents and Forms

Document Name Document Type
Form Client 6-Month Int 6 Month Followup Form and Instruction
Client 6-Month Int Client 6-Month Interview Att 02_Client 6Month Interview.docx Form and Instruction

Information Collection (IC) Details

IC Title:	6 Month Followup	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form and Instruction	Client 6-Month Interview	Client 6-Month Interview	Att 02_Client 6Month Interview.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,708	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	4,708	4,708
Annual IC Time Burden (Hours)	1,883	1,883
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.