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Participant 6-month Follow-up Survey
Job Search Assistance Strategies (JSA) Evaluation - Contact updates, Interim Surveys and Six-Month Follow-up Survey
OMB: 0970-0440
IC ID: 219036
OMB.report
HHS/ACF
OMB 0970-0440
ICR 201703-0970-006
IC 219036
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0440 can be found here:
2018-01-23 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
JSA OMB - Attachment C - Six-Month Follow-Up Survey - Revised 8-19-16 - clean.docx
Other-Survey
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Participant 6-month Follow-up Survey
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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-Survey
JSA OMB - Attachment C - Six-Month Follow-Up Survey - Revised 8-19-16 - clean.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:
3,200
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
3,200
0
0
0
0
3,200
Annual IC Time Burden (Hours)
1,066
0
0
0
0
1,066
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.