Information Collection

Household survey

IC 247024 under ICR 202101-2528-009 · OMB 2528-0332.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Final-4-27-21-Appendix A_Household Survey.docx	Other-Household Survey
Final-4-27-21-Appendix A_Household Survey.docx	Other-Household Survey

IC Title:

Household survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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-Household Survey			Final-4-27-21-Appendix A_Household Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,388

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,388	2,388
Annual IC Time Burden (Hours)	1,385	1,385
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.