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National Family Caregiver Support Program (NFCSP) Outcome Evaluation 6 month follow up
National Family Caregiver Support Program (NFCSP) Outcome Evaluation
OMB: 0985-0052
IC ID: 218509
OMB.report
HHS/ACL
OMB 0985-0052
ICR 201510-0985-001
IC 218509
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0052 can be found here:
2017-05-22 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
National Family Caregiver Support Program (NFCSP) Outcome Evaluation 6 month follow up
Form and Instruction
1 National Family Caregiver Support Program 6 month follow
Appendix_H_NFCSP_CaregiverParticipantGroupSurvey_6-Month.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Family Caregiver Support Program (NFCSP) Outcome Evaluation 6 month follow up
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
Form and Instruction
1
National Family Caregiver Support Program 6 month followup
Appendix_H_NFCSP_CaregiverParticipantGroupSurvey_6-Month.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,250
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
1,250
0
1,250
0
0
0
Annual IC Time Burden (Hours)
838
0
838
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.