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Project Director Survey
Minority AIDS Initiative – Survey of Grantee Project Directors
OMB: 0930-0372
IC ID: 224762
OMB.report
HHS/SAMHSA
OMB 0930-0372
ICR 201612-0930-004
IC 224762
( )
Documents and Forms
Document Name
Document Type
Form PD Survey
Project Director Survey
Form and Instruction
PD Survey PD Survey
AttachA PD Survey 7.29.16.docx
Form and Instruction
AttachB IRB_Initial_Determination_Notice_study_exemptv2012.pdf
IRB
IC Document
AttachC Comment.pdf
Comment
IC Document
AttachD Response Comment.doc
Response Comment
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Project Director 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 and Instruction
PD Survey
PD Survey
AttachA PD Survey 7.29.16.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
100
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
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
100
0
100
0
0
0
Annual IC Time Burden (Hours)
100
0
100
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
IRB
AttachB IRB_Initial_Determination_Notice_study_exemptv2012.pdf
12/13/2016
Comment
AttachC Comment.pdf
12/13/2016
Response Comment
AttachD Response Comment.doc
12/13/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.