Information Collection

Adult Protective Services Outcomes Study

IC 238792 under ICR 202003-0985-001 · OMB 0985-0065.

Documents and Forms

Documents and forms in this information collection
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
APS Client Questionnaire Web Version APS_Client_Outcomes_Study_Client_Questionnaire_v4_83C Tracked.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of 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
Form and Instruction	NA	APS Client Questionnaire Web Version	APS_Client_Outcomes_Study_Client_Questionnaire_v4_83C Tracked.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: 6,024

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
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

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.