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OAHM Client Program Questionnaire (Baseline)
Evaluation of the Older Adults Home Modification Grant Program
OMB: 2528-0335
IC ID: 250815
OMB.report
HUD/PD&R
OMB 2528-0335
ICR 202207-2528-003
IC 250815
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2528-0335 can be found here:
2024-10-15 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Appendix C. Client Program Questionnaire_OAHM_Final.docx
Other-OAHM Client Program Questionna
Appendix C. Client Program Questionnaire_OAHM_FINAL_SPL.docx
Other-OAHM Client Program Questionna
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
OAHM Client Program Questionnaire (Baseline)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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-OAHM Client Program Questionnaire (Baseline)
Appendix C. Client Program Questionnaire_OAHM_Final.docx
No
Paper Only
Other-OAHM Client Program Questionnaire (Baseline)
Appendix C. Client Program Questionnaire_OAHM_FINAL_SPL.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Community and Regional Development
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,000
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
3,000
0
0
0
0
3,000
Annual IC Time Burden (Hours)
300
0
0
0
0
300
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.