Informed Consent Form And Baseline Information Form For Study Participants

SCSEP Older Workers Study Impact Evaluation

Documents and Forms

Document Name Document Type
Attachment 1 - Consent Form and BIF for Study Participants 2 3 25_clean.docx Other-INFORMED CONSENT FORM AND BASE

Information Collection (IC) Details

IC Title:	INFORMED CONSENT FORM AND BASELINE INFORMATION FORM FOR STUDY PARTICIPANTS	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-INFORMED CONSENT FORM AND BASELINE INFORMATION FORM FOR STUDY PARTICIPANTS			Attachment 1 - Consent Form and BIF for Study Participants 2 3 25_clean.docx		Yes	Yes	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,600	1,600
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	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.