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Collaborative Assessment Tool (THRIVE Awardees)
Comprehensive HIV Prevention and Care for Men Who Have Sex with Men of Color
OMB: 0920-1178
IC ID: 224637
OMB.report
HHS/CDC
OMB 0920-1178
ICR 201911-0920-006
IC 224637
( )
Documents and Forms
Document Name
Document Type
Att 6_Annual Collaborative Assessment Tool.docx
Instruction
Att 11_THRIVE_CAT_screenshots.docx
Other-screenshots
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Collaborative Assessment Tool (THRIVE Awardees)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Instruction
Att 6_Annual Collaborative Assessment Tool.docx
Yes
Yes
Fillable Fileable
Other-screenshots
Att 11_THRIVE_CAT_screenshots.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:
7
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
7
0
0
0
0
7
Annual IC Time Burden (Hours)
2
0
0
0
0
2
Annual IC Cost Burden (Dollars)
60
0
0
0
0
60
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.