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Community Residents
Girls at Greater Risk for Juvenile Delinquency and HIV Prevention Program
OMB: 0990-0360
IC ID: 194099
OMB.report
HHS/HHSDM
OMB 0990-0360
ICR 201309-0990-002
IC 194099
( )
Documents and Forms
Document Name
Document Type
20078 ID_0990-0360Respondent-Community resident workshop evaluation.doc
Other-form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Community Residents
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-form
20078 ID_0990-0360Respondent-Community resident workshop evaluation.doc
No
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
250
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
250
0
0
0
0
250
Annual IC Time Burden (Hours)
21
0
0
0
0
21
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.