FSS PHA Staff Interviews Pre-Interview

Family Self-Sufficiency Program Evaluation

Documents and Forms

Document Name Document Type
Protocol 5_PHA Staff Interviews_Pre-Interview Tables_FINAL_with burden statement 03-02-2018.docx Other-FSS PHA Staff Interviews Pre-I

Information Collection (IC) Details

IC Title:	FSS PHA Staff Interviews Pre-Interview	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-FSS PHA Staff Interviews Pre-Interview			Protocol 5_PHA Staff Interviews_Pre-Interview Tables_FINAL_with burden statement 03-02-2018.docx		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 18	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	18	18
Annual IC Time Burden (Hours)	9	9
Annual IC Cost Burden (Dollars)	233	233

Documents for IC

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.