View Information Collection (IC)

View Information Collection (IC)

UC Questionnaires (Forms M-12A-B, E) - Recordkeeping
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form M-12A UC Questionnaire - Ages 6-12 Years Old - English M-12A UC Questionnaire - Ages 6-12 Years Old - Clean.docx Yes Yes Fillable Fileable
Form and Instruction Form M-12B UC Questionnaire - Ages 13 and Older - English M-12B UC Questionnaire - Ages 13 and Older - Clean.docx Yes Yes Fillable Fileable
Form and Instruction Form M-12E UC Questionnaire - Ages 5 and Under - English UC Questionnaire - Ages 5 and Under - English (Form M-12E).docx Yes Yes Fillable Fileable
Form and Instruction Form M-12As UC Questionnaire - Ages 6-12 Years Old - Spanish UC Questionnaire - Ages 6-12 Years Old - Spanish (Form M-12As).docx Yes Yes Fillable Fileable
Form and Instruction Form M-12Bs UC Questionnaire - Ages 13 and Older - Spanish UC Questionnaire - Ages 13 and Older - Spanish (Form M-12Bs).docx Yes Yes Fillable Fileable
Form and Instruction Form M-12Es UC Questionnaire - Ages 5 and Under - Spanish UC Questionnaire - Ages 5 and Under - Spanish (Form M-12Es).docx Yes Yes Fillable Fileable

Community and Social Services Social Services

 

4 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  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 132 0 0 0 0 132
Annual IC Time Burden (Hours) 66 0 0 0 0 66
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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