Information Collection

Outcomes and impacts data - Standardized instruments: Review records and submit (Appendix G)

IC 234668 under ICR 202202-0970-006 · OMB 0970-0527.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0527 can be found here:

Documents and Forms

Document Name Document Type
Appendix G_Standardized Instruments_Outcome and Impact Data_CLEAN.docx Other-Data Elements
Appendix G_Standardized Instruments_Outcome and Impact Data_CLEAN.docx Other-Data Elements

Information Collection (IC) Details

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IC Title:	Outcomes and impacts data - Standardized instruments: Review records and submit (Appendix G)	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-Data Elements			Appendix G_Standardized Instruments_Outcome and Impact Data_CLEAN.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 18	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	36	-4,514	4,550
Annual IC Time Burden (Hours)	900	-4,788	5,688
Annual IC Cost Burden (Dollars)	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.