New Instruments 5,6,12: Second Follow-Up Survey

Personal Responsibility Education Program (PREP) Multi-Component Evaluation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0398 can be found here:

Documents and Forms

Document Name Document Type
New Instrument # 5 - Master Follow-Up Survey.docx Other-Survey
New Instrument #6 - HFSA Follow-Up Survey.docx Other-Survey
PREP NY Follow-up Survey.12.23.13_clean.docx Other-Survey

Information Collection (IC) Details

IC Title:	New Instruments 5,6,12: Second Follow-Up Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	New Instrument # 5 - Master Follow-Up Survey.docx	Yes	Yes	Fillable Fileable
Other-Survey	New Instrument #6 - HFSA Follow-Up Survey.docx	Yes	Yes	Fillable Fileable
Other-Survey	PREP NY Follow-up Survey.12.23.13_clean.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: 750	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	750	750
Annual IC Time Burden (Hours)	563	563
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.