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Online survey about advocates' work history and demographics
Domestic Violence Housing First Demonstration Evaluation
OMB: 0990-0458
IC ID: 226033
OMB.report
HHS/HHSDM
OMB 0990-0458
ICR 201902-0990-004
IC 226033
( )
Documents and Forms
Document Name
Document Type
DVHF_Advocate Demographics and Work History_OMB CLEAN 8.9.17.docx
Other-survey
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Online survey about advocates' work history and demographics
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
DVHF_Advocate Demographics and Work History_OMB CLEAN 8.9.17.docx
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
20
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
20
0
0
0
0
20
Annual IC Time Burden (Hours)
5
0
0
0
0
5
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.