PRC Indicator Survey

Prevention Research Centers Program National Evaluation Reporting System

OMB: 0920-0650

IC ID: 37806

Documents and Forms
Information Collection (IC) Details

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PRC Indicator Survey
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Web-based Survey Attachment 4. Web-Based Survey.doc Yes Yes Fillable Fileable

Health Illness Prevention

 

37 0
   
State, Local, and Tribal Governments
 
   100 %

  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 37 0 -29 0 0 66
Annual IC Time Burden (Hours) 222 0 -57 0 0 279
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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