View Information Collection (IC)

View Information Collection (IC)

IC Title:	12-Month Follow-Up Participant Interview (Attachment K)	Agency IC Tracking Number:

Is this a Common Form? No		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-Participant Survey			K_12- to 18-Month Follow-Up Participant Survey_Phase 2_CLEAN.docx		No		Fillable Fileable
Other-K-1: SUD Program Participant Survey			BEES K-1 12- to 18-month Follow-up Participant Survey_clean.docx		Yes	Yes	Fillable Fileable
Other-Survey			K-2 BEES CCC Survey Instrument August 2022_Clean.docx		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: 1,433	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 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	1,433	0	-274	0	0	1,707
Annual IC Time Burden (Hours)	717	0	-137	0	0	854
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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