OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

DATA COLLECTION INSTRUMENTS FOR THE YOUTH FAIR CHANGE PROGRAM EVALUATION

ICR 199503-1205-001 · OMB 1205-0355 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
121411 DATA COLLECTION INSTRUMENTS FOR THE YOUTH FAIR CHANGE PROGRAM EVALUATION Migrated
ICR Details
1205-0355 199503-1205-001
Historical Active
DOL/ETA
DATA COLLECTION INSTRUMENTS FOR THE YOUTH FAIR CHANGE PROGRAM EVALUATION
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 06/02/1995
Retrieve Notice of Action (NOA) 03/06/1995
Approved as amended by DOL's 6/2/95 memorandum to OMB.
  Inventory as of this Action Requested Previously Approved
06/30/1998 06/30/1998
23,090 0 0
3,354 0 0
0 0 0
THE INFORMATION COLLECTED WILL BE USED TO EVALUATE THE "YOUTH FAIR CHANGE" PROGRAM. THE DATA WILL INCLUDE CHARACTERISTICS OF PROGRAM PARTICIPANTS AND OUTCOMES OF COMMUNITY RESIDENTS. RESPONDENTS WILL BE PROGRAM PARTICIPANTS AND COMMUNITY RESIDENTS WHO ARE 14 TO 30 YEARS OLD.
None
None
No
1
IC Title Form No. Form Name
DATA COLLECTION INSTRUMENTS FOR THE YOUTH FAIR CHANGE PROGRAM EVALUATION
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 23,090 0 0 23,090 0 0
Annual Time Burden (Hours) 3,354 0 0 3,354 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/06/1995