Case Enrollment Data - Government

Regional Partnership Grants National Cross-Site Evaluation and Evaluation Technical Assistance

Documents and Forms

Document Name Document Type
III Enrollment and Service Log Data Dictionary_rev copy.pdf III Enrollment and Service Log Data Dictionary_rev copy IC Document

Information Collection (IC) Details

IC Title:	Case Enrollment Data - Government	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation: 42 CFR B (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: Records maintained on individuals	FR Citation: 5 FR 43

Number of Respondents: 27	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-810	810
Annual IC Time Burden (Hours)	-203	203
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
III Enrollment and Service Log Data Dictionary_rev copy	III Enrollment and Service Log Data Dictionary_rev copy.pdf	12/09/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.