Information Collection

12-Month Follow-Up Participant Interview (Attachment K)

IC 243385 under ICR 202105-0970-003 · OMB 0970-0537.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0537 can be found here:

Documents and Forms

Document Name Document Type
K_12- to 18-Month Follow-Up Participant Survey_Phase 2_CLEAN.docx Other-Participant Interview
K_12- to 18-Month Follow-Up Participant Survey_Phase 2_CLEAN.docx Other-Participant Interview

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	12-Month Follow-Up Participant Interview (Attachment K)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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-Participant Interview			K_12- to 18-Month Follow-Up Participant Survey_Phase 2_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: 1,707	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	1,707	1,707
Annual IC Time Burden (Hours)	854	854
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.