Informed Consent to Provide Contact Information

Evaluation of the Eviction Protection Grant Program

Documents and Forms

Document Name Document Type
Final - Appendix E - Consent for Sharing Contact Information.docx Other-Informed Consent to Provide Co
Final - Appendix E - Consent for Sharing Contact Information.docx Other-Informed Consent to Provide Co

Information Collection (IC) Details

IC Title:	Informed Consent to Provide Contact Information	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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-Informed Consent to Provide Contact Information			Final - Appendix E - Consent for Sharing Contact Information.docx		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 147	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	147	147
Annual IC Time Burden (Hours)	25	25
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.