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GONA - Youth
Cross-Community Evaluation of the Native Aspirations Project
OMB: 0930-0315
IC ID: 193424
OMB.report
HHS/SAMHSA
OMB 0930-0315
ICR 201006-0930-003
IC 193424
( )
Documents and Forms
Document Name
Document Type
Form GONA_Youth_Instrum
GONA - Youth
Form and Instruction
GONA_Youth_Instrum GONA_Youth_Instruments
Attachment 3-Key_Informant_GONA_Youth_Instruments.pdf
Form and Instruction
Attachment 4-Key_Informant_GONA_Youth_Supporting.pdf
GONA_Youth_Supporting
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
GONA - Youth
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_Youth_Instruments
GONA_Youth_Instruments
Attachment 3-Key_Informant_GONA_Youth_Instruments.pdf
Yes
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:
150
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 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
150
0
150
0
0
0
Annual IC Time Burden (Hours)
300
0
300
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
GONA_Youth_Supporting
Attachment 4-Key_Informant_GONA_Youth_Supporting.pdf
06/10/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.