Information Collection

Introductory Script--Program Applicants

IC 206719 under ICR 201607-0970-002 · OMB 0970-0439.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Introductory Script--Program Applicants	Form and Instruction
1 Introductory Script - Program Applicants IC 6_Introductory Script for Program Participants_final.docx	Form and Instruction

IC Title:

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Introductory Script - Program Applicants	IC 6_Introductory Script for Program Participants_final.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: 1,050

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,050	-3,150	4,200
Annual IC Time Burden (Hours)	175	-525	700
Annual IC Cost Burden (Dollars)	0	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.