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YTD--Baseline Questionnaire
Youth Transition Process Demonstration Evaluation Collection
OMB: 0960-0687
IC ID: 9741
OMB.report
SSA
OMB 0960-0687
ICR 200806-0960-012
IC 9741
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0687 can be found here:
2012-06-18 - Extension without change of a currently approved collection
2009-05-21 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
YTD--Baseline Questionnaire
Form
Baseline Pre-Notification Letter.pdf
Other-Notification Letter
Baseline Questionnaire for Youth Transition Process Demo
Baseline Questionnaire.pdf
Form
Baseline Consent Forms.pdf
Baseline Consent Forms
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
YTD--Baseline Questionnaire
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Form
N/A
Baseline Questionnaire for Youth Transition Process Demonstration
Baseline Questionnaire.pdf
No
Printable Only
Other-Notification Letter
Baseline Pre-Notification Letter.pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,531
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
2,531
0
0
1,569
0
962
Annual IC Time Burden (Hours)
1,392
0
0
863
0
529
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Baseline Consent Forms
Baseline Consent Forms.pdf
11/13/2008
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.