Information Collection

Participant Exit Survey (Instrument 2, all versions)

IC 223552 under ICR 202606-0970-012 · OMB 0970-0497.

Documents and Forms

Document Name Document Type
Instrument 2a_Participant Exit Survey for high school and older youth - Final for OMB.docx Other-Survey
Instrument 2b_Participant Exit Survey for middle school youth - Final for OMB.docx Other-Survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Participant Exit Survey (Instrument 2, all versions)	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-Survey			Instrument 2a_Participant Exit Survey for high school and older youth - Final for OMB.docx		Yes	Yes	Fillable Fileable
Other-Survey			Instrument 2b_Participant Exit Survey for middle school youth - Final for OMB.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: 195,528	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	65,175	-41,558	106,733
Annual IC Time Burden (Hours)	5,429	-7,024	12,453
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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