Information Collection

The Strategic Prevention Framework State Incentive Grant (SPF SIG) State-Level Interview Protocols

IC 43645 under ICR 200610-0930-005 · OMB 0930-0279.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0279 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CLI - Part I The Strategic Prevention Framework State Incentive Grant (SPF SIG) State-Level Interview Protocols	Form and Instruction
CLI - Part I CLI - Part I CLI Part I instrument OMB version 8-3-06 sent to CSAP .doc	Form and Instruction
CLI - Part II CLI - Part II CLI Part II instrument OMB version 8-3-06 sent to CSAP.doc	Form and Instruction
CLI OMB Appendices A-E 8-03-06.doc CLI - Appendices A-E	IC Document
CLI OMB Appendices F-O 5-22-06.doc CLI - Appendices F-O	IC Document

IC Title:

The Strategic Prevention Framework State Incentive Grant (SPF SIG) State-Level Interview Protocols

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CLI - Part I	CLI - Part I	CLI Part I instrument OMB version 8-3-06 sent to CSAP .doc		No	No	Paper Only
Form and Instruction	CLI - Part II	CLI - Part II	CLI Part II instrument OMB version 8-3-06 sent to CSAP.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 390

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	390	338	52
Annual IC Time Burden (Hours)	6,856	6,622	234
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CLI - Appendices A-E	CLI OMB Appendices A-E 8-03-06.doc	10/13/2006
CLI - Appendices F-O	CLI OMB Appendices F-O 5-22-06.doc	10/13/2006

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