Information Collection

OAA Title III-C Evaluation of the Elderly Nutrition Services Program Outcome

IC 211372 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 Evaluation of the Elderly Nutrition Services Program Outcome	Form
1 ENSP Client Outcomes CAPI Specs ENSP Client Outcomes CAPI Specs (6-9-15)-FINAL clean version.docx	Form

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	1	ENSP Client Outcomes CAPI Specs	ENSP Client Outcomes CAPI Specs (6-9-15)-FINAL clean version.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,400

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	2,400	-7,800	10,200
Annual IC Time Burden (Hours)	192	-3,564	3,756
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.