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Follow-up survey
Adolescent Family Life Program: Prevention Demonstration Projects
OMB: 0990-0291
IC ID: 186484
OMB.report
HHS/HHSDM
OMB 0990-0291
ICR 200809-0990-003
IC 186484
( )
Documents and Forms
Document Name
Document Type
Form 0990-0291
Follow-up survey
Form
0990-0291 Follow-up survey
0990-0291Appendix B_Draft Prevention Follow up for grantees_OMB_09-02-08_JG_MK.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Follow-up survey
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
Form
0990-0291
Follow-up survey
0990-0291Appendix B_Draft Prevention Follow up for grantees_OMB_09-02-08_JG_MK.doc
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
40,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
40,000
0
40,000
0
0
0
Annual IC Time Burden (Hours)
14,667
0
14,667
0
0
0
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.