Information Collection

Dissolved Partnership Provider Semi-structured Interview Protocol

IC 248444 under ICR 202112-0970-012 · OMB 0970-0471.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 4. Dissolved Partnership Provider Semi-structured Interview Protocol_Revised_CLEAN.docx	Other-Interview Protocol
Instrument 4. Dissolved Partnership Provider Semi-structured Interview Protocol_Revised_CLEAN.docx	Other-Interview Protocol

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-Interview Protocol			Instrument 4. Dissolved Partnership Provider Semi-structured Interview Protocol_Revised_CLEAN.docx		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: 48

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 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	16	16
Annual IC Time Burden (Hours)	13	13
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.