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State Systems Interview Guide for Innovation Grants
Autism CARES Act Initiative Evaluation
OMB: 0915-0335
IC ID: 209769
OMB.report
HHS/HSA
OMB 0915-0335
ICR 202306-0915-005
IC 209769
( )
Documents and Forms
Document Name
Document Type
Attachment E. State Systems Grantee Interview Guide-5.12_JPB 5-26-23.docx
Instruction
Attachment E. State Systems Grantee Interview Guide-5.12_JPB 5-26-23.docx
Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
State Systems Interview Guide for Innovation Grants
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
Instruction
Attachment E. State Systems Grantee Interview Guide-5.12_JPB 5-26-23.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
5
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
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
5
0
-31
0
0
36
Annual IC Time Burden (Hours)
8
0
-28
0
0
36
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.