Information Collection

Instrument 5a & 5b: HPOG 2.0 National Evaluation welcome packet, letter and participant contact update forms

IC 224101 under ICR 201707-0970-001 · OMB 0970-0462.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0462 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 5a_HPOG 2 0 National Evaluation Welcome Packet and Contact Update_REV07112017_clean.docx	Other-Welcome Packet
Instrument 5b_ HPOG 2 0 National Evaluation Contact Update Letter and Form_Rev07112017_clean.docx	Other-Contact Update

IC Title:

Instrument 5a & 5b: HPOG 2.0 National Evaluation welcome packet, letter and participant contact update forms

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
Other-Welcome Packet			Instrument 5a_HPOG 2 0 National Evaluation Welcome Packet and Contact Update_REV07112017_clean.docx		Yes	Yes	Printable Only
Other-Contact Update			Instrument 5b_ HPOG 2 0 National Evaluation Contact Update Letter and Form_Rev07112017_clean.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: 5,250

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	21,000	21,000
Annual IC Time Burden (Hours)	2,100	2,100
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.