Information Collection

Study participants baseline interview

IC 268414 under ICR 202502-0960-014 · OMB 0960-0840.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ICAP SHIPS BaselineInterviewDemographics (revised).pdf	Other-ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewDemographics (revised).pdf	Other-ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewDisabilityHis V2.pdf	Other-ICAP SHIP Baseline Interview D
ICAP SHIPS BaselineInterviewDisabilityHis V2.pdf	Other-ICAP SHIP Baseline Interview D
ICAP SHIPS BaselineInterviewEmploymentInc V2.pdf	Other-ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewEmploymentInc V2.pdf	Other-ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewFinancialDist V2.pdf	Other- ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewFinancialDist V2.pdf	Other- ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewHousingHistor V2.pdf	Other-ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewHousingHistor V2.pdf	Other-ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewLifetimeJusti V2.pdf	Other- ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewLifetimeJusti V2.pdf	Other- ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewSatisfactionW V2.pdf	Other-ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewSatisfactionW V2.pdf	Other-ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewSF12_SHIPS V2.pdf	Other- ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewSF12_SHIPS V2.pdf	Other- ICAP SHIPS Baseline Interview
ICAP SHIPS BaselineInterviewSocialCapital V2.pdf	Other-ICAP SHIPS Baseline InterviewS
ICAP SHIPS BaselineInterviewSocialCapital V2.pdf	Other-ICAP SHIPS Baseline InterviewS
ICAP SHIPS consent form (revised).pdf	Other- ICAP SHIPS consent form
ICAP SHIPS consent form (revised).pdf	Other- ICAP SHIPS consent form
ICAP SHIPS BaselineInterviewDemographics (current).pdf ICAP SHIPS BaselineInterviewDemographics (current)	IC Document
ICAP SHIPS BaselineInterviewDemographics (current).pdf ICAP SHIPS BaselineInterviewDemographics (current)	IC Document
ICAP SHIPS consent form (current).pdf CAP SHIPS consent form (current)	IC Document
ICAP SHIPS consent form (current).pdf CAP SHIPS consent form (current)	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Study participants baseline interview

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	Available Electronically?	Electronic Capability
Other-ICAP SHIPS Baseline Interview Demographics	No	Paper Only
Other-ICAP SHIP Baseline Interview Disability	No	Paper Only
Other-ICAP SHIPS Baseline Interview Employment	No	Paper Only
Other- ICAP SHIPS Baseline Interview Financial	No	Paper Only
Other-ICAP SHIPS Baseline Interview Housing History	No	Printable Only
Other- ICAP SHIPS Baseline Interview Lifetime	No	Paper Only
Other-ICAP SHIPS Baseline Interview Satisfaction	No	Paper Only
Other- ICAP SHIPS Baseline Interview SF12_SHIPS	No	Paper Only
Other-ICAP SHIPS Baseline InterviewSocial Capital	No	Paper Only
Other- ICAP SHIPS consent form	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

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	200	200
Annual IC Time Burden (Hours)	580	580
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ICAP SHIPS BaselineInterviewDemographics (current)		07/02/2025
CAP SHIPS consent form (current)		07/02/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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