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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
BASELINE SURVEY
New
10100
7575
0
Other- Revised - Instrument 2 HCV Mobility Evaluation Baseline Survey
COST DATA COLLECTION INTERVIEW GUIDE
New
34
68
0
Other-Revised - Instrument 8 Interview Guide for Cost Data Collection
COST STUDY DATA COLLECTION OUTREACH
New
34
6
0
Other-Revised - Attachment M Cost Interview Advance Letter
HEAD OF HOUSEHOLD FAMILY INTERVIEW CONSENT FORM
New
180
45
0
Other-Revised - Attachment H Head of Household Family Interview Consent Form
HEAD OF HOUSEHOLD WAITLIST FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION
New
3166
792
0
Other-Revised - Attachment C Head of Household Waitlist Family Informed Consent
HOUSEHOLD ROSTER AND BASELINE INFORMATION FORM
New
10100
7575
0
Other- Revised - Instrument 1 Household Roster and Baseline Information Form
Head of Household Family Interview Advance Letter Evaluation of the Housing Choice Voucher Mobility Demonstration
New
180
31
0
Other-Revised - Attachment I Family Interview Advance Letter
Head of Household Family Interview Email Reminder Evaluation of the Housing Choice Voucher Mobility Demonstration
New
180
14
0
Other-Revised - Attachment J Family Interview Email Reminder
INTERVIEW GUIDE FOR OPPORTUNITY AREA LANDLORDS
New
36
36
0
Other- Revised - Instrument 7 Interview Guide for Participating Landlords
INTERVIEW GUIDE FOR PARTICIPATING FAMILIES CURRENTLY SEARCHING FOR HOUSING
New
90
135
0
Other-Revised - Instrument 5 Interview Guide for Searching Families
INTERVIEW GUIDE FOR PARTICIPATING FAMILIES WHO HAVE LEASED UP
New
90
135
0
Other-Revised - Instrument 6 Interview Guide for Leased Up Families
Landlord Interview Advance Letter Evaluation of the Housing Choice Voucher Mobility Demonstration
New
72
12
0
Other-Revised - Attachment L Landlord Interview Advance Letter
MOBILITY SERVICES PROVIDERS INTERVIEW GUIDE
New
45
68
0
Other- Revised - Instrument 4 Mobility Services Provider Interview Guide
Mobility Services Provider Interview Outreach Evaluation of the Housing Choice Voucher Mobility Demonstration
New
45
8
0
Other-Revised - Attachment K Mobility Services Provider Interview Advance Letter
Mobility Services Tracking Tool Evaluation of the Housing Choice Voucher Mobility Demonstration
New
45360
9072
0
Other-Revised - Attachment G Mobility Services Tracking Tool
OTHER ADULT HOUSEHOLD MEMBER INFORMED CONSENT FOR STUDY PARTICIPATION
New
10100
2525
0
Other-Revised - Attachment D Other Adult Household Member Informed Consent
PARENT/GUARDIAN PERMISSION FORM
New
10100
2525
0
Other-Revised - Attachment E Parent Guardian Permission Form
PHA STAFF INTERVIEW GUIDE
New
45
68
0
Other- Revised - Instrument 3 PHA Staff Interview Guide
PHASE 1- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION
New
6334
1584
0
Other- Revised - Attachment B Head of Household Existing Voucher Holders Informed Consent
PHASE 2- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION
New
400
100
0
Other-Revised - Attachment N Phase 2 HoH Existing Voucher Holders Informed Consent
PHASE 2- HEAD OF HOUSEHOLD WAITLIST FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION
New
200
50
0
Other- Revised - Attachment O Phase 2 Head of Household Waitlist Families Informed Consent
PHASE 2- OTHER ADULT HOUSEHOLD MEMBER INFORMED CONSENT FOR STUDY PARTICIPATION
New
5050
1263
0
Other- Revised - Attachment P Phase 2 Other Adult Household Member Informed Consent
Total burden requested under this ICR:
101941
33687
0
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