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The Hotline/LIR Exit Survey
Accomplishments of the Domestic Violence Hotline, Online Connections and Text (ADVHOCaT) Study
OMB: 0970-0468
IC ID: 226497
OMB.report
HHS/ACF
OMB 0970-0468
ICR 201801-0970-006
IC 226497
( )
Documents and Forms
Document Name
Document Type
Instrument 1 - Exit Survey - edited 1-24-18_clean.docx
Other-Exit Survey
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
The Hotline/LIR Exit Survey
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-Exit Survey
Instrument 1 - Exit Survey - edited 1-24-18_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:
1,100
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
1,100
0
0
0
0
1,100
Annual IC Time Burden (Hours)
165
0
0
0
0
165
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.