OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Instrument 1: Screener for selecting fatherhood sites – Screened, not selected for data collection

IC 239031 under ICR 202004-0970-014 · OMB 0970-0540.

Documents and Forms
Document Name
Document Type
Other-Screener
Information Collection (IC) Details

View Information Collection (IC)

Instrument 1: Screener for selecting fatherhood sites – Screened, not selected for data collection
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Screener Instrument 1 CHaRMED Program Visit Screener.docx Yes Yes Fillable Fileable

Community and Social Services Social Services

 

10 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 10 0 0 0 0 10
Annual IC Time Burden (Hours) 5 0 0 0 0 5
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.