Phase 1- Head Of Household Existing Voucher Family Informed Consent For Study Participation

The Community Choice Demonstration

Documents and Forms

Document Name Document Type
Revised - Attachment B Head of Household Existing Voucher Holders Informed Consent.docx Other-Revised - Attachment B Head of
Revised - Attachment B Head of Household Existing Voucher Holders Informed Consent.docx Other-Revised - Attachment B Head of
Revised - Attachment B Head of Household Existing Voucher Holders Informed Consent - CLEAN.docx Other-Revised - Attachment B Head of
Revised - Attachment B Head of Household Existing Voucher Holders Informed Consent - CLEAN.docx Other-Revised - Attachment B Head of

Information Collection (IC) Details

IC Title:	PHASE 1- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION	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-Revised - Attachment B Head of Household Existing Voucher Holders Informed Consent			Revised - Attachment B Head of Household Existing Voucher Holders Informed Consent.docx		Yes	Yes	Fillable Fileable
Other-Revised - Attachment B Head of Household Existing Voucher Holders Informed Consent			Revised - Attachment B Head of Household Existing Voucher Holders Informed Consent - CLEAN.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,334	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	6,334	6,334
Annual IC Time Burden (Hours)	1,584	1,584
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.