FASD P-CAP Biannual

Fetal Alcohol Spectrum Disorder (FASD) Center for Excellence Parent-Child Assistance Program (P-CAP)

Documents and Forms

Document Name Document Type
Form Biannual Form FASD P-CAP Biannual Form and Instruction
Biannual Form Biannual Form 7 Biannual Form.pdf Form and Instruction
Attachment II and III.zip Attachment II and III IC Document

Information Collection (IC) Details

IC Title:	FASD P-CAP Biannual	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	Biannual Form	Biannual Form	7 Biannual Form.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 161	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	322	322
Annual IC Time Burden (Hours)	106	106
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment II and III	Attachment II and III.zip	10/27/2009

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