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Program Participants (girl and female adolescents)
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 201309-0990-002
IC 194091
( )
Documents and Forms
Document Name
Document Type
20078 ID_OMB 0360 Respondent-Program Participants aged 9-11 years follow-up instrument 9_14_10.doc
Other-study
20078 ID_OMB 0360 Respondent-Program Participants aged 12-17 years pre-test instrument 9_16_10.doc
Other-study
20078_ID_0990-0360 Appendix_A3_Background_on_girls_JD_and_HIV-mp.doc
Other-study
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Program Participants (girl and female adolescents)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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-study
20078 ID_OMB 0360 Respondent-Program Participants aged 9-11 years follow-up instrument 9_14_10.doc
No
No
Fillable Printable
Other-study
20078 ID_OMB 0360 Respondent-Program Participants aged 12-17 years pre-test instrument 9_16_10.doc
No
No
Fillable Printable
Other-study
20078_ID_0990-0360 Appendix_A3_Background_on_girls_JD_and_HIV-mp.doc
No
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
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 %
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
1,500
0
0
0
0
1,500
Annual IC Time Burden (Hours)
3,000
0
0
0
0
3,000
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.