Information Collection

Family survey

IC 264188 under ICR 202405-0970-007 · OMB 0970-0625.

Documents and Forms

Document Name Document Type
Instrument 6. Family Survey_12.15.23_clean.docx Other-Survey
Instrument 6. Family Survey_12.15.23_clean.docx Other-Survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Family survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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-Survey			Instrument 6. Family Survey_12.15.23_clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 332	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	332	166	166
Annual IC Time Burden (Hours)	83	41	42
Annual IC Cost Burden (Dollars)	0	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.