OMB
.report
Search
Follow-up Survey for 15 months
Federal Evaluation of Making Proud Choices! (MPC!
OMB: 0990-0452
IC ID: 226561
OMB.report
HHS/HHSDM
OMB 0990-0452
ICR 201704-0990-005
IC 226561
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0452 can be found here:
2020-08-03 - No material or nonsubstantive change to a currently approved collection
2020-03-09 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
0990-0452Instrument 1_FollowUp_Survey.docx
Other-survey
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Follow-up Survey for 15 months
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-survey
0990-0452Instrument 1_FollowUp_Survey.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
774
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
774
0
774
0
0
0
Annual IC Time Burden (Hours)
387
0
387
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.