Information Collection

OAHM Client Program Questionnaire (Baseline)

IC 250815 under ICR 202411-2528-002 · OMB 2528-0335.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix C. Client Program Questionnaire_OAHM_Final.docx	Other-OAHM Client Program Questionna
Appendix C. Client Program Questionnaire_OAHM_Final.docx	Other-OAHM Client Program Questionna
Appendix C. Client Program Questionnaire_OAHM_FINAL_SPL.docx	Other-OAHM Client Program Questionna
Appendix C. Client Program Questionnaire_OAHM_FINAL_SPL.docx	Other-OAHM Client Program Questionna
Appendix C. Client Program Questionnaire_EOAHMP-C2.DRAFT (clean).docx	Other-Appendix C. Client Program Que
Appendix C. Client Program Questionnaire_EOAHMP-C2.DRAFT (clean).docx	Other-Appendix C. Client Program Que
REV.Client Program Questionnaire_EOAHMP-C2(Baseline and Post) (CLEAN).docx	Other-REV Client Program Questionnai
REV.Client Program Questionnaire_EOAHMP-C2(Baseline and Post) (CLEAN).docx	Other-REV Client Program Questionnai

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-OAHM Client Program Questionnaire (Baseline)	Appendix C. Client Program Questionnaire_OAHM_Final.docx	No	Paper Only
Other-OAHM Client Program Questionnaire (Baseline)	Appendix C. Client Program Questionnaire_OAHM_FINAL_SPL.docx	No	Paper Only
Other-Appendix C. Client Program Questionnaire_EOAHMP-C2.DRAFT (clean)	Appendix C. Client Program Questionnaire_EOAHMP-C2.DRAFT (clean).docx	No	Paper Only
Other-REV Client Program Questionnaire	REV.Client Program Questionnaire_EOAHMP-C2(Baseline and Post) (CLEAN).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: 3,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.