Instrument #18: Questionnaires for Participants in Focus Group with Hispanic Population Focus

Parents and Children Together (PACT) Evaluation

Documents and Forms

Document Name Document Type
PACT Instrument (18) - Questionnaires - 8-23-13.docx Other-Questionaire

Information Collection (IC) Details

IC Title:	Instrument #18: Questionnaires for Participants in Focus Group with Hispanic Population Focus	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
Other-Questionaire			PACT Instrument (18) - Questionnaires - 8-23-13.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: 20	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.