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Federal forms, ICRs, and supporting documents

Information Collection

Head of Household (Pre-test 2, rural feasibility pilot in Garrett County, full implementation pilot in Baltimore City) Head of Household Questionnaire

IC 250653 under ICR 202208-0920-008 · OMB 0920-1356.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Head of Household (Pre-test 2, rural feasibility pilot in Garrett County, full implementation pilot in Baltimore City) Head of Household Questionnaire
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Head of Household Questionnaire Attachment E_Head of Household Questionnaire.pdf NA Yes Yes Fillable Fileable

Health Public Health Monitoring

 

632 0
   
Individuals or Households
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 632 0 0 0 0 632
Annual IC Time Burden (Hours) 158 0 0 0 0 158
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.