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Instrument 2: Impact Evaluation Final Report Template
Healthy Marriage and Responsible Fatherhood Local Evaluation Final Report Templates
OMB: 0970-0640
IC ID: 272759
OMB.report
HHS/ACF
OMB 0970-0640
ICR 202502-0970-037
IC 272759
( )
Documents and Forms
Document Name
Document Type
Instrument 2_Impact Evaluation Final Report Template.clean.docx
Other-Report Template
Instrument 2_Impact Evaluation Final Report Template.clean.docx
Other-Report Template
Appendix B_Instructions for the Impact Evaluation Final Report Template.clean.docx
Instruction
Appendix B_Instructions for the Impact Evaluation Final Report Template.clean.docx
Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Instrument 2: Impact Evaluation Final Report Template
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Report Template
Instrument 2_Impact Evaluation Final Report Template.clean.docx
Yes
Yes
Fillable Printable
Instruction
Appendix B_Instructions for the Impact Evaluation Final Report Template.clean.docx
Yes
Yes
Fillable Printable
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:
29
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
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
29
0
0
0
0
29
Annual IC Time Burden (Hours)
870
0
0
0
0
870
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.