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Program Participants (girls and female adolecents)
Girls at Greater Risk for Juvenile Delinquency and HIV Prevention Program
OMB: 0990-0360
IC ID: 194091
OMB.report
HHS/HHSDM
OMB 0990-0360
ICR 201008-0990-001
IC 194091
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0360 can be found here:
2013-09-30 - Extension without change of a currently approved collection
2010-09-27 - New collection (Request for a new OMB Control Number)
Documents and Forms
Document Name
Document Type
0990-GirlsBackground Form Participants final (3).doc
Other-questions
Appendix D 6 12-17 GEARS proposed JD-HIV Instrument follow up 7_23_10 final.doc
Other-survey
Appendix D.5 12-17 GEARS proposed JD-HIV Instrument post test 7_23_10 final.doc
Other-survey
Appendix D.4 12-17 GEARS prposed JD-HIV Instrument pre-test 7_23_10 final.doc
Other-survey
0990-Girlsat risk Appendix D.1 9-11 GEARS proposed JD-HIV Instrument pre-test.docx
Other-survey
0990-Appendix D 2 9-11 GEARS proposed JD-HIV Instrument post-test.docx
Other-questionnaire
0990-Appendix D 3 9-11 GEARS proposed JD HIV instrument follow up.doc
Other-questionnaire
0990-girlsAppendix_A 1_Overview_of_OWH's_HIV_AIDS_Programs_revised_3_10.doc
0990-girlsAppendix_A 1_Overview_of_OWH's_HIV_AIDS_Programs_revised_3_10
IC Document
0990-Girls at riskAppendix G-Items and Sources for GEARS proposed JD-HIV Instruments July 12 2010.doc
0990-Girls at riskAppendix G-Items and Sources for GEARS proposed JD-HIV Instruments July 12 2010
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Program Participants (girls and female adolecents)
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-questions
0990-GirlsBackground Form Participants final (3).doc
No
No
Paper Only
Other-survey
Appendix D 6 12-17 GEARS proposed JD-HIV Instrument follow up 7_23_10 final.doc
No
No
Paper Only
Other-survey
Appendix D.5 12-17 GEARS proposed JD-HIV Instrument post test 7_23_10 final.doc
No
No
Paper Only
Other-survey
Appendix D.4 12-17 GEARS prposed JD-HIV Instrument pre-test 7_23_10 final.doc
No
No
Paper Only
Other-survey
0990-Girlsat risk Appendix D.1 9-11 GEARS proposed JD-HIV Instrument pre-test.docx
No
No
Paper Only
Other-questionnaire
0990-Appendix D 2 9-11 GEARS proposed JD-HIV Instrument post-test.docx
No
No
Paper Only
Other-questionnaire
0990-Appendix D 3 9-11 GEARS proposed JD HIV instrument follow up.doc
No
No
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:
750
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
1,500
0
1,500
0
0
0
Annual IC Time Burden (Hours)
3,000
0
3,000
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
0990-girlsAppendix_A 1_Overview_of_OWH's_HIV_AIDS_Programs_revised_3_10
0990-girlsAppendix_A 1_Overview_of_OWH's_HIV_AIDS_Programs_revised_3_10.doc
07/23/2010
0990-Girls at riskAppendix G-Items and Sources for GEARS proposed JD-HIV Instruments July 12 2010
0990-Girls at riskAppendix G-Items and Sources for GEARS proposed JD-HIV Instruments July 12 2010.doc
07/23/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.