Information Collection

Strategic Prevention Framework State Incentive Grant (SPF SIG) Program - Community

IC 191137 under ICR 201105-0930-001 · OMB 0930-0279.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0279 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form A1b SPFSIGI_IICLIP Strategic Prevention Framework State Incentive Grant (SPF SIG) Program - Community	Form and Instruction
A1b SPFSIGI_IICLIP A1b SPFSIGI_IICLIPart1 A1b SPFSIGI_IICLIPart1.doc	Form and Instruction
A1c SPFSIGI_IICLIP A1c SPFSIGI_IICLIPart2 A1c SPFSIGI_IICLIPart2.doc	Form and Instruction
A1a SPFSIG 1-2 Pha A1a SPFSIG 1-2 Phase 2_Follow Up_Sustainability A1a SPFSIG 1-2 Phase 2_Follow Up_Sustainability_7-6-10rec4-7-11.doc	Form and Instruction
A2 SPFSIGIII_IV_VInstrumentReviewers rec 407.doc A2 SPFSIGIII_IV_VInstrumentReviewers	IC Document

IC Title:

Strategic Prevention Framework State Incentive Grant (SPF SIG) Program - Community

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	A1b SPFSIGI_IICLIPart1	A1b SPFSIGI_IICLIPart1	A1b SPFSIGI_IICLIPart1.doc	Yes	Yes	Paper Only
Form and Instruction	A1c SPFSIGI_IICLIPart2	A1c SPFSIGI_IICLIPart2	A1c SPFSIGI_IICLIPart2.doc	Yes	Yes	Paper Only
Form and Instruction	A1a SPFSIG 1-2 Phase 2_Follow Up_Sustainability	A1a SPFSIG 1-2 Phase 2_Follow Up_Sustainability	A1a SPFSIG 1-2 Phase 2_Follow Up_Sustainability_7-6-10rec4-7-11.doc	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,208

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	Previously Approved
Annual Number of Responses for this IC	5,424	317	5,107
Annual IC Time Burden (Hours)	5,842	342	5,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
A2 SPFSIGIII_IV_VInstrumentReviewers	A2 SPFSIGIII_IV_VInstrumentReviewers rec 407.doc	04/07/2011

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