AFI 36-Month Follow-up Questionnaire: AFI-eligible participants

Assets for Independence (AFI) Program Evaluation

Documents and Forms

Document Name Document Type
AFI Follow-Up Questionnaire - Final.docx Other-Questionnaire
AFI Follow-Up Questionnaire - Final w. changes highlighted.docx UPDATES HIGHLIGHTED: AFI 36-Month Follow-up Questionnaire IC Document

Information Collection (IC) Details

IC Title:	AFI 36-Month Follow-up Questionnaire: AFI-eligible participants	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-Questionnaire			AFI Follow-Up Questionnaire - Final.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: 271	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	271	271
Annual IC Time Burden (Hours)	271	271
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
UPDATES HIGHLIGHTED: AFI 36-Month Follow-up Questionnaire	AFI Follow-Up Questionnaire - Final w. changes highlighted.docx	09/01/2015

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