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Pre-Test ND-PAE
Improving Fetal Alcohol Spectrum Disorders Prevention and Practice through Practice and Implementation Centers and National Partnerships
OMB: 0920-1129
IC ID: 245663
OMB.report
HHS/CDC
OMB 0920-1129
ICR 202102-0920-003
IC 245663
( )
Documents and Forms
Document Name
Document Type
Form 0920-1129
Pre-Test ND-PAE
Form and Instruction
0920-1129 B11 Pre-test ND-PAE
B11 Pre-test ND-PAE.docx
Form and Instruction
0920-1129 B11 Pre-test ND-PAE
B11 Pre-test ND-PAE.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Pre-Test ND-PAE
Agency IC Tracking Number:
0920-1129
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
42 CFR 241
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
0920-1129
B11 Pre-test ND-PAE
B11 Pre-test ND-PAE.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
120
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
120
0
120
0
0
0
Annual IC Time Burden (Hours)
20
0
20
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.