Information Collection

OAA Title III-C Elderly Nutrition Services Program Evaluation - SUA

IC 207134 under ICR 201612-0985-002 · OMB 0985-0037.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 OAA Title III-C Elderly Nutrition Services Program Evaluation - SUA	Form and Instruction
1 ENSP Evaluation State Unit on Aging collection ENSP_Eval_DataCollection_PartB_AppendixC.pdf	Form and Instruction
PartB-AppB-11-27-12.pdf PartB-AppB-11-27-12	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	ENSP Evaluation State Unit on Aging collection	ENSP_Eval_DataCollection_PartB_AppendixC.pdf		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: 56

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	94	94
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
PartB-AppB-11-27-12	PartB-AppB-11-27-12.pdf	05/17/2013

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