Site visit and key informant data collection: Sustainability survey (Appendix D)

CB Evaluation: Regional Partnership Grants (RPG) National Cross-Site Evaluation and Evaluation Technical Assistance [Implementation/descriptive study and Outcomes/Impact analyses]

Documents and Forms

Document Name Document Type
Appendix D_Sustainability Survey_CLEAN.docx Other-Survey
Appendix D_Sustainability Survey_CLEAN.docx Other-Survey

Information Collection (IC) Details

IC Title:	Site visit and key informant data collection: Sustainability survey (Appendix D)	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-Survey			Appendix D_Sustainability Survey_CLEAN.docx		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 252	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	106	53	53
Annual IC Time Burden (Hours)	35	17	18
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.