Information Collection

Survey Instrument

IC 9803 under ICR 201603-0970-014 · OMB 0970-0033.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0033 can be found here:

Documents and Forms

Document Name Document Type
Annual Survey Refugees Updated Questionnaire for OMB - English FINAL .doc Other-Questionnaire
Annual Survey Refugees Updated Questionnaire for OMB - English FINAL Track Changes.pdf Updated ASR Questionnaire - Track Changes IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Survey Instrument	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 4 CFR 45

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire			Annual Survey Refugees Updated Questionnaire for OMB - English FINAL .doc		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	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	Previously Approved
Annual Number of Responses for this IC	2,000	0	2,000
Annual IC Time Burden (Hours)	1,000	-240	1,240
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Updated ASR Questionnaire - Track Changes	Annual Survey Refugees Updated Questionnaire for OMB - English FINAL Track Changes.pdf	03/21/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.