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OAA Title III-C Evaluation of the Elderly Nutrition Services Program Outcome
OAA Title III-C Evaluation of the Elderly Nutrition Services Program
OMB: 0985-0037
IC ID: 211372
OMB.report
HHS/ACL
OMB 0985-0037
ICR 201612-0985-002
IC 211372
( )
Documents and Forms
Document Name
Document Type
Form 1
OAA Title III-C Evaluation of the Elderly Nutrition Services Program Outcome
Form
1 ENSP Client Outcomes CAPI Specs
ENSP Client Outcomes CAPI Specs (6-9-15)-FINAL clean version.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
OAA Title III-C Evaluation of the Elderly Nutrition Services Program Outcome
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
Form
1
ENSP Client Outcomes CAPI Specs
ENSP Client Outcomes CAPI Specs (6-9-15)-FINAL clean version.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,400
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
2,400
0
-7,800
0
0
10,200
Annual IC Time Burden (Hours)
192
0
-3,564
0
0
3,756
Annual IC Cost Burden (Dollars)
0
0
0
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.