Information Collection

Young Adult 15 Month Tracking Survey

IC 213457 under ICR 201410-0970-006 · OMB 0970-0383.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0383 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Young Adult 15 Month Tracking Survey	Form and Instruction
1 Young Adult 15 mos Tracking 2015 Attachment_F_Young Adult 15 mos Tracking 2015.docx	Form and Instruction

IC Title:

Young Adult 15 Month Tracking Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Young Adult 15 mos Tracking 2015	Attachment_F_Young Adult 15 mos Tracking 2015.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	170	170
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.