Information Collection

RHY-HMIS: Street Outreach Program (Contact)

IC 245725 under ICR 202508-0970-010 · OMB 0970-0573.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 RHY-HMIS Data Elements RHY-HMIS: Street Outreach Program (Contact)	Form
HMIS-Data-Standards-Manual-2024_EO Update.pdf	Instruction
1 RHY-HMIS Data Elements RHY Program Specific Data Elements OMB -Updated 08202025 for EO Requirement.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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
Form	1				Yes	Yes	Fillable Fileable
Instruction					Yes	Yes	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 108,000

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	Previously Approved
Annual Number of Responses for this IC	35,640	35,640
Annual IC Time Burden (Hours)	18,000	18,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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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