Information Collection

Care Recipients of NFCSP Clients

IC 218514 under ICR 201705-0985-002 · OMB 0985-0052.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Care Recipients of NFCSP Clients	Form and Instruction
1 Caregiver Comparison Group Survey Baseline Appendix_J_CaregiverComparisonGroupSurvey_Baseline.docx	Form and Instruction

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	Caregiver Comparison Group Survey Baseline	Appendix_J_CaregiverComparisonGroupSurvey_Baseline.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: 1,250

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	Previously Approved
Annual Number of Responses for this IC	1,250	1,250
Annual IC Time Burden (Hours)	206	206
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.