National Family Caregiver Support Program Outcome Evaluation - 12 month followup

National Family Caregiver Support Program (NFCSP) Outcome Evaluation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0052 can be found here:

Documents and Forms

Document Name Document Type
Form 1 National Family Caregiver Support Program Outcome Evaluation - 12 month followup Form and Instruction
1 National Family Caregiver Participant Survey 12 month su Appendix_J_CaregiverComparisonGroupSurvey_Baseline.docx Form and Instruction

Information Collection (IC) Details

IC Title:	National Family Caregiver Support Program Outcome Evaluation - 12 month followup	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
Form and Instruction	1	National Family Caregiver Participant Survey 12 month survey	Appendix_J_CaregiverComparisonGroupSurvey_Baseline.docx		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: 1,250	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	1,250	1,250
Annual IC Time Burden (Hours)	838	838
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.