Information Collection

Training and Technical Assistance Performance Measures

IC 203454 under ICR 201103-0930-003 · OMB 0930-0197.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0197 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachment A Training and Technical Assistance Performance Measures	Form and Instruction
Attachment A Performance Measures Attachment A Training and TA Performance Measures110929.docx	Form and Instruction
705Attachment B Staff and Consultants Involved111004.docx Staff and Consultants Involved	IC Document
705-12OMBTASupportingStatement_7.11.12.docx Justification	IC Document
Trans.Let-5-2012.doc Letter/Memo	IC Document

IC Title:

Training and Technical Assistance Performance Measures

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Attachment A	Performance Measures	Attachment A Training and TA Performance Measures110929.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,694

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,694	4,694
Annual IC Time Burden (Hours)	389	389
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Staff and Consultants Involved	705Attachment B Staff and Consultants Involved111004.docx	07/12/2012
Justification	705-12OMBTASupportingStatement_7.11.12.docx	07/12/2012
Letter/Memo	Trans.Let-5-2012.doc	07/12/2012

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