Interviewing

Evaluation of the Community Healthy Marriage Initiatives (CHMI) - Baseline survey

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0322 can be found here:

Documents and Forms

Document Name Document Type
CHMI baseline survey - Instrument 2- part (a) Questionaire sections A-C.03.22.07.doc Other-Interviewing

Information Collection (IC) Details

IC Title:	Interviewing	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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-Interviewing			CHMI baseline survey - Instrument 2- part (a) Questionaire sections A-C.03.22.07.doc		No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,200	4,200
Annual IC Time Burden (Hours)	2,772	2,772
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.