Information Collection

Grantee Survey

IC 234055 under ICR 201811-1290-001 · OMB 1290-0026.

Documents and Forms

Document Name Document Type
REO 50503 Grantee survey_June2019_CLEAN.DOCX Other-Survey
REO 50503 Participant consent form_June2019_CLEAN.DOCX Participant Consent Form IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Grantee Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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			REO 50503 Grantee survey_June2019_CLEAN.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: 32	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	32	32
Annual IC Time Burden (Hours)	11	11
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Participant Consent Form	REO 50503 Participant consent form_June2019_CLEAN.DOCX	06/28/2019

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