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Community Based Abstinence Education (Follow-up Test Survey)
Community-Based Abstinence Education
OMB: 0970-0272
IC ID: 190225
OMB.report
HHS/ACF
OMB 0970-0272
ICR 200908-0970-005
IC 190225
( )
Documents and Forms
Document Name
Document Type
Form 1
Community Based Abstinence Education (Follow-up Test Survey)
Form
1 Follow-up
FR 0970-0272 Core measure survey follow-up (post-post) test 7-27-09.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Community Based Abstinence Education (Follow-up 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
Form
1
Follow-up
FR 0970-0272 Core measure survey follow-up (post-post) test 7-27-09.doc
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
500,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
87 %
Requested
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
500,000
0
500,000
0
0
0
Annual IC Time Burden (Hours)
125,000
0
125,000
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.
