Information Collection

RHY-HMIS: Basic Center Program (Exit)

IC 245722 under ICR 202102-0970-006 · OMB 0970-0573.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0573 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 RHY-HMIS: Basic Center Program (Exit)	Form
FY 2020 HMIS-Data-Standards-Manual.pdf	Instruction
FY 2020 HMIS-Data-Standards-Manual.pdf	Instruction
1 RHY-HMIS Data Elements RHY Program Specific Data Elements OMB V2.pdf	Form
1 RHY-HMIS Data Elements RHY Program Specific Data Elements OMB V2.pdf	Form

IC Title:

RHY-HMIS: Basic Center Program (Exit)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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
Form	1	RHY-HMIS Data Elements	RHY Program Specific Data Elements OMB V2.pdf		Yes	Yes	Fillable Fileable
Instruction			FY 2020 HMIS-Data-Standards-Manual.pdf		Yes	Yes	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 123,000

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
Annual Number of Responses for this IC	40,590	40,590
Annual IC Time Burden (Hours)	13,530	13,530
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.