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Federal forms, ICRs, and supporting documents

Information Collection

Household Roster And Baseline Information Form

IC 266058 under ICR 202502-2528-005 · OMB 2528-0337.

Documents and Forms
Document Name
Document Type
Other-Revised - Instrument 1 Househo
Other-Revised - Instrument 1 Househo
Information Collection (IC) Details

View Information Collection (IC)

HOUSEHOLD ROSTER AND BASELINE INFORMATION FORM
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Revised - Instrument 1 Household Roster and Baseline Information Form_Rev_24August2022 Revised - Instrument 1 Household Roster and Baseline Information Form_Rev_24August2022.docx Yes Yes Fillable Fileable

Community and Social Services Community and Regional Development

 

10,100 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 10,100 0 0 0 0 10,100
Annual IC Time Burden (Hours) 7,575 0 0 0 0 7,575
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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