NYSS Champion Application

Prevention Communication Formative Research

Documents and Forms

Document Name Document Type
Form 1 NYSS Champion Application Form and Instruction
1 NYSS Champion Program Application Attachment A. NYSS Champions Application Form.pdf health.gov/our-work/nutrition-physical-activity/national-youth-sports-strategy/nyss-champions Form and Instruction
NYSS Champions Application 0990-0281 Supporting Statement A_7.25.docx NYSS Champions Application Supplementary Part A IC Document

Information Collection (IC) Details

IC Title:	NYSS Champion Application	Agency IC Tracking Number:

IC Status: Unchanged

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	1	NYSS Champion Program Application	Attachment A. NYSS Champions Application Form.pdf	https://health.gov/our-work/nutrition-physical-activity/national-youth-sports-strategy/nyss-champions	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 75	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	75	75
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NYSS Champions Application Supplementary Part A	NYSS Champions Application 0990-0281 Supporting Statement A_7.25.docx	07/25/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.