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Community Readiness
Cross-Community Evaluation of the Native Aspirations Project
OMB: 0930-0315
IC ID: 193429
OMB.report
HHS/SAMHSA
OMB 0930-0315
ICR 201006-0930-003
IC 193429
( )
Documents and Forms
Document Name
Document Type
Form Community_Readines
Community Readiness
Form and Instruction
Community_Readines Community_Readiness_Instruments
Attachment 13-Community_Readiness_Instruments.pdf
Form and Instruction
Attachment 14-Community_Readiness_Supporting.pdf
Community_Readiness_Supporting
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Community Readiness
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
Community_Readiness_Instruments
Community_Readiness_Instruments
Attachment 13-Community_Readiness_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:
84
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
84
0
84
0
0
0
Annual IC Time Burden (Hours)
84
0
84
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Community_Readiness_Supporting
Attachment 14-Community_Readiness_Supporting.pdf
06/10/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.