Information Collection

Instrument 8: Demographic questionnaire – fathers

IC 239054 under ICR 202004-0970-014 · OMB 0970-0540.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 8 Brief questionnaire fathers_clean.docx	Other-Questionnaire

IC Title:

Instrument 8: Demographic questionnaire â fathers

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire			Instrument 8 Brief questionnaire fathers_clean.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: 72

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	72	-52	124
Annual IC Time Burden (Hours)	18	-13	31
Annual IC Cost Burden (Dollars)	0	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.