Information Collection

Outcomes and impacts data - Administrative data: Report administrative data (Appendix H)

IC 234666 under ICR 202506-0970-007 · OMB 0970-0527.

Documents and Forms

Document Name Document Type
Appendix H_Administrative Data Elements_Outcome and Impact Analysis.docx Other-Admin Data
Appendix H_Administrative Data Elements_Outcome and Impact Analysis.docx Other-Admin Data

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Outcomes and impacts data - Administrative data: Report administrative data (Appendix H)	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-Admin Data			Appendix H_Administrative Data Elements_Outcome and Impact Analysis.docx		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: 18	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	36	-36	72
Annual IC Time Burden (Hours)	2,916	-7,452	10,368
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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

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