Prevention Services Data Collection

Documents and Forms

Document Name Document Type
Form 1 Prevention Services Data Collection Form and Instruction
1 PSDC Elements Technical-bulletin_Prevention Services Data_0970-0529.pdf Form and Instruction
1 PSDC Elements Technical-bulletin_Prevention Services Data_0970-0529.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Prevention Services Data Collection	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	PSDC Elements	Technical-bulletin_Prevention Services Data_0970-0529.pdf		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: 55	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	110	70	40
Annual IC Time Burden (Hours)	3,410	2,170	1,240
Annual IC Cost Burden (Dollars)	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.