Information Collection

Adult Protective Services Outcomes Study

IC 238792 under ICR 201912-0985-001 · OMB 0985-0065.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0065 can be found here:

Documents and Forms

Document Name Document Type
Adult Protective Services Outcomes Study Form and Instruction
APS_Client_Outcomes_Study_Client_Questionnaire_Information_Sheet.pdf Other-Study Respondent Information
APS Client Questionnaire APS_Client_Outcomes_Study_Client_Questionnaire (2) (002).docx Form and Instruction
APS Client Interview APS_Client_Outcomes_Study_Interview_Guide_Clients (5).docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Adult Protective Services Outcomes Study	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	APS Client Questionnaire	APS_Client_Outcomes_Study_Client_Questionnaire (2) (002).docx	Yes	Yes	Fillable Fileable
Form and Instruction	NA	APS Client Interview	APS_Client_Outcomes_Study_Interview_Guide_Clients (5).docx	Yes	Yes	Fillable Fileable
Other-Study Respondent Information			APS_Client_Outcomes_Study_Client_Questionnaire_Information_Sheet.pdf	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: 6,024	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	6,024	6,024
Annual IC Time Burden (Hours)	1,020	1,020
Annual IC Cost Burden (Dollars)	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.