Information Collection

48 Month Survey

IC 203686 under ICR 201504-1205-005 · OMB 1205-0503.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
01-APP_A_48MSurvey_CATI.pdf	Other-survey
03-APP_A2_Informed Consent 12-Month Survey.pdf	Other-informed consent
04-APP_A3_48MSurvey_WebSpecs.pdf	Other-survey
06-App_B_Advance Letter_Follow-up_Survey (09-11-15).pdf Advance Letter	IC Document
07-App_B1_Advance Email_T_and_C.pdf Advance Letter Email Version	IC Document
08-App_C_Interim_Letter_Follow-up_Survey.pdf Participant Interim Letter	IC Document
05-APP_A4_48MSurvey_WebSpecs_Tracked_Changes.pdf 5. Survey Instrument – Web Version with track changes noting changes from previously approved survey (Appendix A4)	IC Document
11-App_E_FAQs_Follow-up_Survey.pdf 11. Frequently Asked Questions (Appendix E)	IC Document
02-APP_A1_ 48MSurvey_CATI_Tracked_Changes.pdf Appendix A1 Youthbuild 48-month Follow-Up Survey CATI	IC Document

IC Title:

48 Month Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey	04-APP_A3_48MSurvey_WebSpecs.pdf	Yes	Yes	Fillable Fileable
Other-survey	01-APP_A_48MSurvey_CATI.pdf	Yes	Yes	Fillable Fileable
Other-informed consent	03-APP_A2_Informed Consent 12-Month Survey.pdf	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,749

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	Previously Approved
Annual Number of Responses for this IC	2,749	-23	2,772
Annual IC Time Burden (Hours)	1,604	-244	1,848
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Advance Letter	06-App_B_Advance Letter_Follow-up_Survey (09-11-15).pdf	10/02/2015
Advance Letter Email Version	07-App_B1_Advance Email_T_and_C.pdf	10/02/2015
Participant Interim Letter	08-App_C_Interim_Letter_Follow-up_Survey.pdf	10/02/2015
5. Survey Instrument â Web Version with track changes noting changes from previously approved survey (Appendix A4)	05-APP_A4_48MSurvey_WebSpecs_Tracked_Changes.pdf	10/02/2015
11. Frequently Asked Questions (Appendix E)	11-App_E_FAQs_Follow-up_Survey.pdf	10/02/2015
Appendix A1 Youthbuild 48-month Follow-Up Survey CATI	02-APP_A1_ 48MSurvey_CATI_Tracked_Changes.pdf	10/02/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.