Project Prevent Needs Assessment Template

Master Generic Plan for Customer Surveys and Focus Groups

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1800-0011 can be found here:

Documents and Forms

Document Name Document Type
Project Prevent Needs Assessment Template Form and Instruction
Project Prevent Nov 2014 Initial Needs Assessment v3 (10 29 2014).docx Form and Instruction
Att_Generic_Clearance_OMB_Template_Instrument_NEEDS_ASSESSMENTS_PP grant....docx Generic Template IC Document

Information Collection (IC) Details

IC Title:	Project Prevent Needs Assessment Template	Agency IC Tracking Number:	182

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 and Instruction	N/A	N/A	Project Prevent Nov 2014 Initial Needs Assessment v3 (10 29 2014).docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 22	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	22	22
Annual IC Time Burden (Hours)	22	22
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Template	Att_Generic_Clearance_OMB_Template_Instrument_NEEDS_ASSESSMENTS_PP grant....docx	11/10/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.