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Public Health AmeriCorps Grantee Focus Group
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 3045-0137
IC ID: 260451
OMB.report
CNCS
OMB 3045-0137
ICR 202303-3045-002
IC 260451
( )
Documents and Forms
Document Name
Document Type
Form 1
Public Health AmeriCorps Grantee Focus Group
Form and Instruction
1 PHA Focus Group
PublicHealthAmeriCorps grantee focus group instrument_5.20.23 OMB.docx
www.americorps.gov
Form and Instruction
Generic Clearance Submission_PHA Evaluation_Grantee Focus Group.docx
Public Health AmeriCorps Grantee Focus Group
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Public Health AmeriCorps Grantee Focus Group
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
42 CFR 12501
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
1
PHA Focus Group
PublicHealthAmeriCorps grantee focus group instrument_5.20.23 OMB.docx
www.americorps.gov
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Community and Regional Development
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
15
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
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
15
0
15
0
0
0
Annual IC Time Burden (Hours)
23
0
23
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Public Health AmeriCorps Grantee Focus Group
Generic Clearance Submission_PHA Evaluation_Grantee Focus Group.docx
05/30/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.