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MFS-IP Follow up Survey- 34 months-Male
Evaluation of The Marriage and Family Strengthening Grants
OMB: 0990-0331
IC ID: 184574
OMB.report
HHS/HHSDM
OMB 0990-0331
ICR 201405-0990-005
IC 184574
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0331 can be found here:
2015-07-31 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
0990-0331Renewal Appendix A Male Instrument.pdf
Other-survey
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
MFS-IP Follow up Survey- 34 months-Male
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
0990-0331Renewal Appendix A Male Instrument.pdf
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
463
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
463
0
0
0
0
463
Annual IC Time Burden (Hours)
695
0
0
0
0
695
Annual IC Cost Burden (Dollars)
0
0
0
0
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.