View Information Collection (IC)

View Information Collection (IC)

Head of Household (Pre-test 2, rural feasibility pilot in Garrett County, full implementation pilot in Baltimore City) Head of Household Questionnaire
No New

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Head of Household Questionnaire Attachment E_Head of Household Questionnaire.pdf NA Yes Yes Fillable Fileable

Health Public Health Monitoring


632 0
Individuals or Households
   100 %

  Approved 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 632 0 632 0 0 0
Annual IC Time Burden (Hours) 158 0 158 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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