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Program Report Tool - Annual Reporting
Monitoring and Reporting System for Rape Prevention and Education (RPE) Program Awardees
OMB: 0920-1130
IC ID: 221590
OMB.report
HHS/CDC
OMB 0920-1130
ICR 201703-0920-012
IC 221590
( )
Documents and Forms
Document Name
Document Type
Program Report Tool - Annual Reporting
Form
Rape Prevention and Education Program Report Tool
Att._4b_Program_Report_Tool_Screenshots_041416.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Program Report Tool - Annual Reporting
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
none
Rape Prevention and Education Program Report Tool
Att._4b_Program_Report_Tool_Screenshots_041416.pdf
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:
55
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
55
0
0
0
0
55
Annual IC Time Burden (Hours)
165
0
0
0
0
165
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.