Baseline information form for participants (Attachment D)

OPRE Evaluation - Building Evidence on Employment Strategies for Low-Income Families (BEES) [Impact, implementation, and descriptive studies]

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0537 can be found here:

Documents and Forms

Document Name Document Type
D_Baseline Information Form for Participants_final 11.8.19.docx Other-null

Information Collection (IC) Details

IC Title:	Baseline information form for participants (Attachment D)	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-null			D_Baseline Information Form for Participants_final 11.8.19.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: 4,133	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	4,133	4,133
Annual IC Time Burden (Hours)	1,034	1,034
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.