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HPOG-Impact 36-month Control Group Follow-Up survey
Health Profession Opportunity Grants (HPOG) program: Third Follow-Up Data Collection
OMB: 0970-0394
IC ID: 212774
OMB.report
HHS/ACF
OMB 0970-0394
ICR 202007-0970-008
IC 212774
( )
Documents and Forms
Document Name
Document Type
HPOG Followup OMB Appendix L1 36-Month Control.docx
Other-Survey
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
HPOG-Impact 36-month Control Group Follow-Up survey
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
HPOG Followup OMB Appendix L1 36-Month Control.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
737
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
737
0
0
0
0
737
Annual IC Time Burden (Hours)
737
0
0
0
0
737
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.