Information Collection

Second Follow-Up Survey

IC 207455 under ICR 201711-0970-001 · OMB 0970-0398.

Documents and Forms

Document Name Document Type
New Instrument # 5 - Master Follow-Up Survey.docx Other-Survey
New Instrument #6 - HFSA Follow-Up Survey.docx Other-Survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Second Follow-Up Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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-Survey			New Instrument # 5 - Master Follow-Up Survey.docx		Yes	Yes	Fillable Fileable
Other-Survey			New Instrument #6 - HFSA Follow-Up Survey.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: 325	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	325	-425	750
Annual IC Time Burden (Hours)	244	-319	563
Annual IC Cost Burden (Dollars)	0	0	0

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.