SURVEY OF SERVICES PROVIDED BY ADOLESCENT PREGNANCY PROGRAMS

ICR 197908-0937-003

OMB: 0937-0063

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0937-0063 197908-0937-003
Historical Active
HHS/OASH
SURVEY OF SERVICES PROVIDED BY ADOLESCENT PREGNANCY PROGRAMS
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 09/14/1979
Retrieve Notice of Action (NOA) 08/24/1979
  Inventory as of this Action Requested Previously Approved
07/31/1980 07/31/1980
2,000 0 0
1,250 0 0
0 0 0



None
None


No

1
IC Title Form No. Form Name
SURVEY OF SERVICES PROVIDED BY ADOLESCENT PREGNANCY PROGRAMS

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,000 0 0 0 2,000 0
Annual Time Burden (Hours) 1,250 0 0 0 1,250 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/24/1979


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