View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Street Outreach Program Data Collection Project	Agency IC Tracking Number:

IC Status: Modified

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-Interview			Attachment B Interview Questions revised-clean.pdf		Yes	Yes	Fillable Fileable
Other-Focus Group			Attachment F Focus Group Questions revised-clean.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 880	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	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	880	0	0	0	0	880
Annual IC Time Burden (Hours)	1,100	0	0	0	0	1,100
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
SOP Data Collection Project -- SSA Template revised-clean	SOP Data Collection Project -- SSA Template revised-clean.pdf	05/16/2013
Attach C Seed Coupon	Attach C Seed Coupon.pdf	08/13/2012
Attach D Focus Group Brochure	Attach D Focus Group Brochure.pdf	08/13/2012
Attachment H Interview Consent Non-Seed revised-clean	Attachment H Interview Consent Non-Seed revised-clean.pdf	05/16/2013
Attach I IRB Approval	Attach I IRB Approval.pdf	08/13/2012
SOP DC Project-OMB Information Request -- References List	SOP DC Project-OMB Information Request -- References List.docx	08/13/2012
Attachment A Interview Brochure revised-clean	Attachment A Interview Brochure revised-clean.pdf	05/16/2013
SOP Data Collection Project -- SSB Template revised-clean	SOP Data Collection Project -- SSB Template revised-clean.pdf	05/16/2013
Attachment E Focus Group Consent revised-clean	Attachment E Focus Group Consent revised-clean.pdf	05/16/2013
Attachment G Interview Consent Seed revised-clean	Attachment G Interview Consent Seed revised-clean.pdf	05/16/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.