Contact Form

Replication of Recovery and Reunification Interventions forFamilies-Impact Study (R3-Impact)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0616 can be found here:

Documents and Forms

Document Name Document Type
Instr.2_Contact Form.docx Other-Contact Form
Instr.2_Contact Form.docx Other-Contact Form

Information Collection (IC) Details

IC Title:	Contact Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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-Contact Form			Instr.2_Contact Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title: OPRE Research and Evaluation Project Records	FR Citation: 87 FR 57198

Number of Respondents: 1,843	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,457	2,457
Annual IC Time Burden (Hours)	418	418
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.