New Instrument 3: Implementation site data collection

Personal Responsibility Education Program (PREP) Multi-Component Evaluation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0398 can be found here:

Documents and Forms

Document Name Document Type
PREP PAS+Baseline - Instrument 3 - Implementation Site Data Collection - 6-7-12.docx Other-Data Collection

Information Collection (IC) Details

IC Title:	New Instrument 3: Implementation site data collection	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
Other-Data Collection			PREP PAS+Baseline - Instrument 3 - Implementation Site Data Collection - 6-7-12.docx		No	No	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,400	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
Annual Number of Responses for this IC	1,400	1,400
Annual IC Time Burden (Hours)	11,200	11,200
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.