10 & 11 - 6 month follow-up surveys

Building Bridges and Bonds (B3)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0485 can be found here:

Documents and Forms

Document Name Document Type
10 - 6 Month Follow-up Survey for Sites testing Parenting Intervention_01_20_17.docx Other-Follow up survey
11 - 6 Month Follow-up Employment Questionnaire Draft 1-20-17.docx Other-Follow up survey

Information Collection (IC) Details

IC Title:	10 & 11 - 6 month follow-up surveys	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
Other-Follow up survey			10 - 6 Month Follow-up Survey for Sites testing Parenting Intervention_01_20_17.docx		Yes	Yes	Fillable Fileable
Other-Follow up survey			11 - 6 Month Follow-up Employment Questionnaire Draft 1-20-17.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: 810	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	810	810
Annual IC Time Burden (Hours)	540	540
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.