72-Month Tracking Survey

Family Options Study: Long-Term Follow-up Evaluation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2528-0259 can be found here:

Documents and Forms

Document Name Document Type
InstrumentC_FOS_72 MonthTracking Survey.doc Other-72-Month Tracking Survey
InstrumentC_FOS_72 MonthTracking Survey.doc 72-Month Tracking Survey IC Document

Information Collection (IC) Details

IC Title:	72-Month Tracking Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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-72-Month Tracking Survey			InstrumentC_FOS_72 MonthTracking Survey.doc		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title: Homeless Families Impact Study Data Files	FR Citation: 79 FR 4202

Number of Respondents: 2,264	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-2,264	2,264
Annual IC Time Burden (Hours)	-566	566
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
72-Month Tracking Survey	InstrumentC_FOS_72 MonthTracking Survey.doc	05/26/2017

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