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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
1: Applicant Characteristics - Program Applicants
Modified
49500
12500
0
Other-Survey
1: Applicant Characteristics - Program Staff
Modified
50050
5005
0
Other-Survey
2: Program Operations
Modified
440
141
0
Other-Survey
3: Service Delivery Data
Modified
47300
23650
0
Other-Reporting System
4: Entrance and Exit Surveys - Program clients (entrance)
Modified
46694
19810
0
Other-HM Adult Entrance Survey
Other-HM Youth Entrance Survey
Other-RF Community Fathers Entrance Survey
Other-RF Community Mothers Entrance Survey
Other-RF Reentering Fathers Entrance Survey
4: Entrance and Exit Surveys - Program clients (exit)
Modified
31262
13263
0
Other-HM Adult Exit Survey
Other-HM Youth Exit Survey
Other-RF Community Fathers Exit Survey
Other-RF Community Mothers Exit Survey
Other-RF Reentering Fathers Exit Survey
4: Entrance and Exit Surveys - Program staff (entrance and exit on paper)
Modified
25740
2574
0
Other-HM Adult Entrance Survey
Other-HM Adult Exit Survey
Other-HM Youth Entrance Survey
Other-HM Youth Exit Survey
Other-RF Community Fathers Entrance Survey
Other-RF Community Fathers Exit Survey
Other-RF Community Mothers Entrance Survey
Other-RF Community Mothers Exit Survey
Other-RF Reentering Fathers Entrance Survey
Other-RF Reentering Fathers Exit Survey
5: Semi-annual Performance Progress Report (PPR)
Modified
220
660
0
Form and Instruction
HM
HM PPR
Form and Instruction
RF
RF PPR
6: Quarterly Performance Report (QPR)
Modified
220
220
0
Form and Instruction
HM
HM QPR
Form and Instruction
RF
RF QPR
7: Continuous Quality Improvement (CQI) Plan
Modified
110
440
0
Other-Template
Total burden requested under this ICR:
251536
78263
0
To view an IC, click on IC Title