Information Collection

Semi-annual Progress Report for the Services to Advocate for and Respond to Youth Program

IC 194376 under ICR 201701-1122-004 · OMB 1122-0025.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1122-0025 Semi-annual Progress Report for the Services to Advocate for and Respond to Youth Program	Form
1122-0025 Semi-Annual Progress Report for the Services to Advocate YouthServFormGMSSample.pdf muskie.usm.maine.edu/vawamei/youthservform.htm	Form

IC Title:

Agency IC Tracking Number:

1122-0025

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	1122-0025	Semi-Annual Progress Report for the Services to Advocate for and Respond to Youth Program	YouthServFormGMSSample.pdf	http://muskie.usm.maine.edu/vawamei/youthservform.htm	Yes	Yes	Fillable Fileable Signable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 45

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	90	90
Annual IC Time Burden (Hours)	90	90
Annual IC Cost Burden (Dollars)	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.