PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
1: Program Application and Enrollment - Program applicants (1b: entrance survey)
Modified
45000
15300
0
Other-Survey
Other-Survey
Other-Survey
Other-Survey
1: Program Application and Enrollment - Program staff (1a: application form)
Modified
45017
4502
0
Other-Application Form
1: Program Application and Enrollment - Program staff (1b: entrance survey data entry)
New
9011
901
0
Other-Survey
Other-Survey
Other-Survey
Other-Survey
2: Program Operations - Program Staff
Modified
109
35
0
Other-Survey
3: Service Delivery Data - Program staff (data entry)
Modified
42510
15304
0
Other-Reporting System
4: Entrance and Exit Surveys - Program clients (exit)
Removed
0
0
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: Exit Surveys - Participants
Modified
29187
8172
0
Other-HM Adult Exit Survey
Other-HM Youth Exit Survey
Other-RF Community Fathers Exit Survey
Other-RF Reentering Fathers Exit Survey
4: Exit Surveys - Program staff (exit survey data entry)
Modified
5813
581
0
Other-HM Adult Exit Survey
Other-HM Youth Exit Survey
Other-RF Community Fathers Exit Survey
Other-RF Reentering Fathers Exit Survey
5: Annual Performance Progress Report (PPR) - Program Staff
Modified
109
327
0
Form and Instruction
1
Annual HMRF PPR
6: Quarterly Performance Report (QPR)
Removed
0
0
0
Form and Instruction
HM2
HM QPR
Form and Instruction
RF2
RF QPR
7: Continuous Quality Improvement (CQI) Plan
Removed
0
0
0
Other-Template
Total burden requested under this ICR:
176756
45122
0
To view an IC, click on IC Title
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