Post screener questions for adults (C.3)

Responding to Intimate Violence in Relationship Programs (RIViR)

OMB: 0970-0503

IC ID: 224370

Documents and Forms
Document Name
Document Type
Other-Post Screener Questions
Information Collection (IC) Details

View Information Collection (IC)

Post screener questions for adults (C.3)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Post Screener Questions Att_C.3 Demographic information_Oct 10 2016.docx Yes Yes Fillable Fileable

Community and Social Services Social Services

 

300 0
   
Individuals or Households
 
   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 300 0 300 0 0 0
Annual IC Time Burden (Hours) 30 0 30 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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