Information Collection

Program Staff

IC 194094 under ICR 201008-0990-001 · OMB 0990-0360.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0360 can be found here:

Documents and Forms

Document Name Document Type
Appendix D 6 12-17 GEARS proposed JD-HIV Instrument follow up 7_23_10 final.doc Other-survey
0990-GirlsAppendix_A 2_Contact_Information-OWH_Contractors_(JD_only).doc Instruction
0990-Appendix D 1 9-11 GEARS proposed JD-HIV Instrument pre-test.docx Other-interview

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Program Staff	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey	Appendix D 6 12-17 GEARS proposed JD-HIV Instrument follow up 7_23_10 final.doc	No	No	Paper Only
Instruction	0990-GirlsAppendix_A 2_Contact_Information-OWH_Contractors_(JD_only).doc	No	No	Paper Only
Other-interview	0990-Appendix D 1 9-11 GEARS proposed JD-HIV Instrument pre-test.docx	No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	750	750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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