Information Collection

OAHM Client Impact Evaluation Interview (Post-modification)

IC 250822 under ICR 202411-2528-002 · OMB 2528-0335.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix F. Client Impact Evaluation Interview Form_OAHM_Final.docx	Other-OAHM Client Impact Evaluation
Appendix F. Client Impact Evaluation Interview Form_OAHM_Final.docx	Other-OAHM Client Impact Evaluation
Appendix F. Client Impact Evaluation Interview Form_OAHM_FINAL_SPL.docx	Other-OAHM Client Impact Evaluation
Appendix F. Client Impact Evaluation Interview Form_OAHM_FINAL_SPL.docx	Other-OAHM Client Impact Evaluation
Appendix F. Client Impact Evaluation Interview_EOAHMP-C2.DRAFT (clean).docx	Other-Appendix F. Client Impact Eval
Appendix F. Client Impact Evaluation Interview_EOAHMP-C2.DRAFT (clean).docx	Other-Appendix F. Client Impact Eval
REV.Client Impact Evaluation Interview_EOAHMP-C2(Baseline and Post).(CLEAN).docx	Other-REV_Client Impact Evaluation
REV.Client Impact Evaluation Interview_EOAHMP-C2(Baseline and Post).(CLEAN).docx	Other-REV_Client Impact Evaluation

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 Impact Evaluation Interview (Post-modification)	Appendix F. Client Impact Evaluation Interview Form_OAHM_Final.docx	No	Paper Only
Other-OAHM Client Impact Evaluation Interview (Post-modification)	Appendix F. Client Impact Evaluation Interview Form_OAHM_FINAL_SPL.docx	No	Paper Only
Other-Appendix F. Client Impact Evaluation Interview_EOAHMP-C2.DRAFT (clean)	Appendix F. Client Impact Evaluation Interview_EOAHMP-C2.DRAFT (clean).docx	No	Paper Only
Other-REV_Client Impact Evaluation	REV.Client Impact Evaluation Interview_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: 1,688

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	1,688	1,688
Annual IC Time Burden (Hours)	557	557
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.