Community Based Abstinence Education (Post-test survey)

Community-Based Abstinence Education

Documents and Forms

Document Name Document Type
Form 1 Community Based Abstinence Education (Post-test survey) Form
1 Post Test FR 0970-0272 Core measure survey post test 7-27-09.doc Form

Information Collection (IC) Details

IC Title:	Community Based Abstinence Education (Post-test 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	1	Post Test	FR 0970-0272 Core measure survey post test 7-27-09.doc		Yes	Yes	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000,000	1,000,000
Annual IC Time Burden (Hours)	250,000	250,000
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.