Information Collection

Interview Guide for Mothers-English and Spanish versions

IC 211364 under ICR 201404-0970-009 · OMB 0970-0448.

Documents and Forms

Document Name Document Type
Interview Guide for Mothers-English.docx Other-Guide
Interview Guide for Mothers-Spanish.docx Other-Guide

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Interview Guide for Mothers-English and Spanish versions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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-Guide			Interview Guide for Mothers-English.docx		No		Paper Only
Other-Guide			Interview Guide for Mothers-Spanish.docx		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	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.