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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

Documents and forms in this information collection
Document NameDocument Type
Head of Household (Pre-test 2, rural feasibility pilot in Garrett County, full implementation pilot in Baltimore City) Head of Household Questionnaire Form and Instruction
Head of Household Questionnaire
Attachment E_Head of Household Questionnaire.pdf 		Form and Instruction
Head of Household Questionnaire
Attachment E_Head of Household Questionnaire.pdf 		Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

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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 and Instruction NA Head of Household Questionnaire Attachment E_Head of Household Questionnaire.pdf NA Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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

Documents for IC
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Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.