GONA - Adult

Cross-Community Evaluation of the Native Aspirations Project

Documents and Forms

Document Name Document Type
Form GONA_Adult_Instrum GONA - Adult Form and Instruction
GONA_Adult_Instrum GONA_Adult_Instruments Attachment 1-Key_Informant GONA_Adult_Instruments.pdf Form and Instruction
Attachment 2-Key_Informant_GONA_Adult_Supporting.pdf GONA_Adult_Supporting IC Document

Information Collection (IC) Details

IC Title:	GONA - Adult	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 and Instruction	GONA_Adult_Instruments	GONA_Adult_Instruments	Attachment 1-Key_Informant GONA_Adult_Instruments.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 125	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
Annual Number of Responses for this IC	125	125
Annual IC Time Burden (Hours)	92	92
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
GONA_Adult_Supporting	Attachment 2-Key_Informant_GONA_Adult_Supporting.pdf	06/10/2010

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.