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MFC-IP Follow-back Interviews Male Pre-release
Evaluation of The Marriage and Family Strengthening Grants
OMB: 0990-0331
IC ID: 212432
OMB.report
HHS/HHSDM
OMB 0990-0331
ICR 201506-0990-005
IC 212432
( )
Documents and Forms
Document Name
Document Type
0990-0331Appendix A_instruments.docx
Other-null
0990-0331NonsubstantiveModificationCombined.docx
MFS-IP Grants
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
MFC-IP Follow-back Interviews Male Pre-release
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-null
0990-0331Appendix A_instruments.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
20
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
20
0
0
0
0
20
Annual IC Time Burden (Hours)
30
0
0
0
0
30
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
MFS-IP Grants
0990-0331NonsubstantiveModificationCombined.docx
07/23/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.