Information Collection

Collection Instruments - Individuals

IC 182736 under ICR 200711-0584-003 · OMB 0584-0547.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0547 can be found here:

Documents and Forms

Document Name Document Type
Participants Focus Groups Discussion Guide.pdf Other-Focus Group Discussion Guide
Information Form.pdf Other-Focus Group Information Form
Intercept Interview.pdf Other-Interview
Participants Focus Groups Discussion Guide.pdf Other-Discussion Guide

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Collection Instruments - Individuals	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Focus Group Discussion Guide	Participants Focus Groups Discussion Guide.pdf	No	Paper Only
Other-Focus Group Information Form	Information Form.pdf	No	Paper Only
Other-Interview	Intercept Interview.pdf	No	Paper Only
Other-Discussion Guide	Participants Focus Groups Discussion Guide.pdf	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 336	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	840	840
Annual IC Time Burden (Hours)	521	521
Annual IC Cost Burden (Dollars)	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.