NOFO: Assessment of Language and Structure

Information Collections to Advance State, Tribal, Local and Territorial (STLT) Governmental Agency System Performance, Capacity, and Program Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
NOFO: Assessment of Language and Structure Form
Attachment D - Telephone Interview Guide.docx Other-Interview Guide
NOFO Assessment Attachment C - Web-Based Data Collection Instrument PDF Version.pdf Form
NOFO-APPL-SSA.docx Supporting Statement A IC Document
NOFO-APPL-SSB.docx Supporting Statement B IC Document
Attachment A - Respondent Breakdown.docx Respondent State Distribution IC Document
Attachment E - Web-based data collection invitation email.docx Invitation email IC Document
Attachment F - Web-Based Data Collection Reminder Email 1.docx Reminder Email IC Document
Attachment G - Web-Based Data Collection Reminder Emails 2.docx Second Reminder Email IC Document
Attachment H - Telephone Invitation Email.docx Telephone Invitation Email IC Document
Attachment I - Telephone Reminder Email.docx Telephone Reminder Email IC Document

Information Collection (IC) Details

IC Title:	NOFO: Assessment of Language and Structure	Agency IC Tracking Number:	0920-0879-19AOH

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	none	NOFO Assessment	Attachment C - Web-Based Data Collection Instrument PDF Version.pdf		Yes	Yes	Fillable Fileable
Other-Interview Guide			Attachment D - Telephone Interview Guide.docx		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 775	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 Agency Discretion
Annual Number of Responses for this IC	775	775
Annual IC Time Burden (Hours)	335	335
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A	NOFO-APPL-SSA.docx	04/11/2019
Supporting Statement B	NOFO-APPL-SSB.docx	04/11/2019
Respondent State Distribution	Attachment A - Respondent Breakdown.docx	04/11/2019
Invitation email	Attachment E - Web-based data collection invitation email.docx	04/11/2019
Reminder Email	Attachment F - Web-Based Data Collection Reminder Email 1.docx	04/11/2019
Second Reminder Email	Attachment G - Web-Based Data Collection Reminder Emails 2.docx	04/11/2019
Telephone Invitation Email	Attachment H - Telephone Invitation Email.docx	04/11/2019
Telephone Reminder Email	Attachment I - Telephone Reminder Email.docx	04/11/2019

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