PATH Provider Web Survey

Evaluation of the Projects for Assistance in Transition from Homelessness (PATH) Program

Documents and Forms

Document Name Document Type
Form PATH Provider Web PATH Provider Web Survey Form and Instruction
PATH Provider Web PATH Provider Web Survey PATH Evaluation_Attachment3_2017_May1.docx Form and Instruction
PATH Provider Web PATH Provider Web Survey PATH Evaluation_Attachment3_2017_May1.docx Form and Instruction

Information Collection (IC) Details

IC Title:	PATH Provider Web Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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
Form and Instruction	PATH Provider Web Survey	PATH Provider Web Survey	PATH Evaluation_Attachment3_2017_May1.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-500	500
Annual IC Time Burden (Hours)	-500	500
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.