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Record Locator Form
Critical Thinking and Cultural Affirmation: Evaluation of a Locally Developed HIV Prevention Intervention
OMB: 0920-0945
IC ID: 202458
OMB.report
HHS/CDC
OMB 0920-0945
ICR 201205-0920-010
IC 202458
( )
Documents and Forms
Document Name
Document Type
Record Locator Form
Form
Record Locator Form
Attachment 7 Record Locator Form.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Record Locator Form
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
none
Record Locator Form
Attachment 7 Record Locator Form.docx
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
146
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
146
0
146
0
0
0
Annual IC Time Burden (Hours)
24
0
24
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.