Information Collection

Chafee Strengthening Outcomes for Transition to Adulthood Project: Impact Evaluation of My First Place

IC 280969 under ICR 202502-0970-044 · OMB 0970-0618.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0618 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument A. MFP Baseline Instrument_clean.docx	Other-Survey
Instrument B. MFP Follow Up Instrument_clean.docx	Other-Survey
Supporting Statement A - Chafee SOTA - MFP_Revised v5_clean.docx SSA - Chafee SOTA GenIC - My First Place	IC Document
Supporting Statement B - Chafee SOTA - MFP_Revised v5_clean.docx SSB - Chafee SOTA GenIC - My First Place	IC Document
Appendix 1_Consent to Contact Form_clean.docx Appendix 1: Consent to Contact Form	IC Document
Appendix 2. Chafee SOTA Frequently Asked Questions_clean.docx Appendix 2: Recruitment FAQs	IC Document
Appendix 3. Study Informed Consent_clean.docx Appendix 3: Informed Consent Form	IC Document

IC Title:

Chafee Strengthening Outcomes for Transition to Adulthood Project: Impact Evaluation of My First Place

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey					Yes	Yes	Fillable Fileable
Other-Survey					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: 600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,680	1,680
Annual IC Time Burden (Hours)	840	840
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - Chafee SOTA GenIC - My First Place		06/15/2026
SSB - Chafee SOTA GenIC - My First Place		06/15/2026
Appendix 1: Consent to Contact Form		06/15/2026
Appendix 2: Recruitment FAQs		06/15/2026
Appendix 3: Informed Consent Form		06/15/2026

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

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