Form 1 Staff Data Entry

Procedural Justice Informed Alternative to Contemp (PJAC)

IC 1 Staff Data Entry for RA

Staff data entry for random assignment

OMB: 0970-0505

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OMB #: XXXX-XXXX

EXPIRATION DATE: XX/XX/201X

INFORMATION COLLECTION ACTIVITY #1

Procedural Justice informed alternatives to contempt (pjac)

Staff Data Entry for Random Assignment

Data Elements



NCP SSN

 


Case ID(s)

 


Type of establishment(s)

 


Order establishment date(s)

 


Open TANF case(s) at time of RA?

 


NCP ever served with contempt (Y/N) and date of most recent occurrence

 


Monthly order amount(s) at time of RA

 


Total arrears amount(s) at time of RA

 




File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleStaff Interviews for Sites Testing CBE
AuthorEmily Brennan
File Modified0000-00-00
File Created2021-01-22

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