Information Collection

Implementation Survey Interview Topic Guide (State-level Respondents)

IC 212733 under ICR 201711-0970-001 · OMB 0970-0398.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
5 Instrument 1_InterviewTopicGuide_2014-08-19-14.docx	Other-Topic Guide

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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-Topic Guide			5 Instrument 1_InterviewTopicGuide_2014-08-19-14.docx		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-6	6
Annual IC Time Burden (Hours)	-6	6
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.