District Assistance Questionnaire

Promoting Adolescent Health through School-Based HIV Prevention

OMB: 0920-1275

IC ID: 237606

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Form and Instruction
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Information Collection (IC) Details

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District Assistance Questionnaire 0920-19AUK
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None PERS: District Assistance Questionnaire Att5_District Assistance Qnr Items.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

25 0
   
State, Local, and Tribal Governments
 
   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 50 0 0 0 0 50
Annual IC Time Burden (Hours) 350 0 0 0 0 350
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Example screenshots (PERS: District Assistance Questionnaire) Att8c-District Assistance Scrn Shot.docx 09/23/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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