Information Collection

Second follow-up survey

IC 234187 under ICR 202008-0970-008 · OMB 0970-0506.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0506 can be found here:

Documents and Forms

Document Name Document Type
Attachment N. Second follow-up survey_rev.docx Other-Survey
Attachment O QXQ for Second follow-up survey_PUBLIC_v3_clean.docx Attachment O - QxQ for Second Follow Up IC Document

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			Attachment N. Second follow-up survey_rev.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: 1,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,600	1,600
Annual IC Time Burden (Hours)	1,200	1,200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment O - QxQ for Second Follow Up	Attachment O QXQ for Second follow-up survey_PUBLIC_v3_clean.docx	11/28/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.