Awardee Lead Profile Assessment (ALPA) Web Survey

Awardee Lead Profile Assessment (ALPA)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1215 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-1215 Awardee Lead Profile Assessment (ALPA) Web Survey Form and Instruction
0920-1215 Awardee Lead Profile Assessment (ALPH) Web Survey Att4a ALPA Web Survey 20200928.docx Form and Instruction
0920-1215 Awardee Lead Profile Assessment (ALPH) Web Survey Att4a ALPA Web Survey 20200928.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Awardee Lead Profile Assessment (ALPA) Web Survey	Agency IC Tracking Number:	0920-1215

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1215	Awardee Lead Profile Assessment (ALPH) Web Survey	Att4a ALPA Web Survey 20200928.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 74	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	Previously Approved
Annual Number of Responses for this IC	74	14	60
Annual IC Time Burden (Hours)	58	11	47
Annual IC Cost Burden (Dollars)	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.