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Instrument 15: Housing Assistance Questionnaire
Evaluation of the Family Unification Program
OMB: 0970-0514
IC ID: 232059
OMB.report
HHS/ACF
OMB 0970-0514
ICR 202108-0970-015
IC 232059
( )
Documents and Forms
Document Name
Document Type
Instrument 15 Housing Assistance Questionnaire.docx
Other-Questionnaire
Instrument 15 Housing Assistance Questionnaire.docx
Other-Questionnaire
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Instrument 15: Housing Assistance Questionnaire
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-Questionnaire
Instrument 15 Housing Assistance Questionnaire.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:
120
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
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
120
0
-81
0
0
201
Annual IC Time Burden (Hours)
11
0
-7
0
0
18
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.