Information Collection

Cross-Site Accountability Assessment of the Residential Treatment for Prgnant and Postpartum Women and Their Minor Children Program (PPW)

IC 7685 under ICR 200811-0930-001 · OMB 0930-0269.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachment F - Ins Cross-Site Accountability Assessment of the Residential Treatment for Prgnant and Postpartum Women and Their Minor Children Program (PPW)	Form and Instruction
Attachment F - Ins Attachment F - Instruments PPW - Instruments.zip	Form and Instruction
Other-PPW-Docs.zip Attachments A-E, G-I	IC Document

IC Title:

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	Attachment F - Instruments	Attachment F - Instruments	PPW - Instruments.zip		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,510

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	57,798	28,899	28,899
Annual IC Time Burden (Hours)	19,684	9,842	9,842
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachments A-E, G-I	Other-PPW-Docs.zip	09/12/2007

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