Information Collection

Consent Agreement & Baseline survey

IC 203701 under ICR 201412-2528-002 · OMB 2528-0293.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2528-0293 can be found here:

Documents and Forms

Document Name Document Type
Appendix C Study Participant Consent Form (3.5.13).docx Other-Telephone Script for Informed
Appendix E Baseline Survey Final (3.5.13).doc Other-Baseline Survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Consent Agreement & Baseline survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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-Telephone Script for Informed Consent			Appendix C Study Participant Consent Form (3.5.13).docx		No		Paper Only
Other-Baseline Survey			Appendix E Baseline Survey Final (3.5.13).doc		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-7,000	7,000
Annual IC Time Burden (Hours)	-4,200	4,200
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.