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First Post-Test Survey
Evauation of the I Can do It, You Can Do It Health Promotion Program fo Children and Youth with Disabilities
OMB: 0990-0328
IC ID: 184941
OMB.report
HHS/HHSDM
OMB 0990-0328
ICR 200805-0990-001
IC 184941
( )
Documents and Forms
Document Name
Document Type
0990-icandoitApril 2008 Agency Post Assessment.pdf
Other-test
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
First Post-Test Survey
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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-test
0990-icandoitApril 2008 Agency Post Assessment.pdf
No
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
510
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
510
0
510
0
0
0
Annual IC Time Burden (Hours)
153
0
153
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.