Community Plan

Cross-Community Evaluation of the Native Aspirations Project

Documents and Forms

Document Name Document Type
Form Informant_Communit Community Plan Form and Instruction
Informant_Communit Informant_Community_Instruments Attachment 5-Key_Informant_Community_Instruments.pdf Form and Instruction
Attachment 6-Key_Informant_Community_Supporting.pdf Community_Supporting IC Document

Information Collection (IC) Details

IC Title:	Community Plan	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	Informant_Community_Instruments	Informant_Community_Instruments	Attachment 5-Key_Informant_Community_Instruments.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 327	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	327	327
Annual IC Time Burden (Hours)	518	518
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Community_Supporting	Attachment 6-Key_Informant_Community_Supporting.pdf	06/10/2010

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