Information Collection

Instrument 14: Randomization Tool

IC 232058 under ICR 202108-0970-015 · OMB 0970-0514.

Documents and Forms

Document Name Document Type
Instrument 14 Randomization Tool.docx Other-Randomization Tool
Instrument 14 Randomization Tool.docx Other-Randomization Tool

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Instrument 14: Randomization Tool	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-Randomization Tool			Instrument 14 Randomization Tool.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: 3	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	200	-224	424
Annual IC Time Burden (Hours)	4	-5	9
Annual IC Cost Burden (Dollars)	0	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.