Information Collection

Evaluation of Adolescent Pregnancy Prevention Approaches (PPA) demonstration

IC 190103 under ICR 200807-0970-012 · OMB 0970-0355.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0355 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PPA - Generic Pre-Test - Append A and B - Baseline Survey and Cog Interviews - 7-17-09.doc	Other-Survey and Cognitive Interview
PPA - Generic Pre-Test - Append A and B - Baseline Surveys and Cog Interviews - 8-25-09.doc	Other-Survey and Cognitive Interview
PPA - Generic Pre-Test - Supporting Statement B - 8-25-09.doc Supporting Statement B - 8-25-09	IC Document
PPA - Generic Pre-Test - Supporting Statement A - 8-25-09.doc Supporting Statement A	IC Document

IC Title:

Evaluation of Adolescent Pregnancy Prevention Approaches (PPA) demonstration

Agency IC Tracking Number:

IC Status: New

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
Other-Survey and Cognitive Interview			PPA - Generic Pre-Test - Append A and B - Baseline Survey and Cog Interviews - 7-17-09.doc		No	Yes	Fillable Printable
Other-Survey and Cognitive Interview			PPA - Generic Pre-Test - Append A and B - Baseline Surveys and Cog Interviews - 8-25-09.doc		No		Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	50	0	0	0	0	0
Annual IC Time Burden (Hours)	75	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement B - 8-25-09	PPA - Generic Pre-Test - Supporting Statement B - 8-25-09.doc	08/28/2009
Supporting Statement A	PPA - Generic Pre-Test - Supporting Statement A - 8-25-09.doc	08/28/2009

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