Information Collection

Instrument 6: Family Interview Protocol

IC 270764 under ICR 202506-0970-022 · OMB 0970-0638.

Documents and Forms

Document Name Document Type
Instrument 6_Family Interview.docx Other-Interview
Instrument 6_Family Interview.docx Other-Interview

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Instrument 6: Family Interview Protocol	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-Interview			Instrument 6_Family Interview.docx		Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	56	14	42
Annual IC Time Burden (Hours)	56	14	42
Annual IC Cost Burden (Dollars)	0	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.

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