Conversation Guide

Understanding the Dynamics of Disconnection from Employment and Assistance

Documents and Forms

Document Name Document Type
Appendix A-9 - Conversation Guide REV.docx Other-Discussion Guide
Appendix A-9S - Conversation Guide (Spanish) REV.docx Appendix A-9S - Conversation Guide (Spanish) IC Document

Information Collection (IC) Details

IC Title:	Conversation Guide	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-Discussion Guide			Appendix A-9 - Conversation Guide REV.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: 66	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	66	66
Annual IC Time Burden (Hours)	99	99
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix A-9S - Conversation Guide (Spanish)	Appendix A-9S - Conversation Guide (Spanish) REV.docx	04/23/2013

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