Director

Program Evaluation for Assertive Adolescent & Family Treatment (AAFT) Program

Documents and Forms

Document Name Document Type
Form Director Survey Director Form and Instruction
Director Survey Director Survey A1 Annual Program Survey (PIs PDs)_FINAL DRAFT_4 26 11.doc Form and Instruction
B1. PI.PD emails.doc PI.PD emails IC Document

Information Collection (IC) Details

IC Title:	Director	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	Director Survey	Director Survey	A1 Annual Program Survey (PIs PDs)_FINAL DRAFT_4 26 11.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 21	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	21	21
Annual IC Time Burden (Hours)	16	16
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
PI.PD emails	B1. PI.PD emails.doc	01/04/2011

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