Information Collection

A Public Health Response to Trauma: Creating Conditions, Connection and Community for Women and Families

IC 203564 under ICR 201106-0990-001 · OMB 0990-0379.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0379 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment for OMB 0990-0379.updated 7.27.12.doc	Other-Customer Comment Card
OMB Fast Track for Trauma Training 3.19.12 updated 7.27.12..docx Supporting Documentation	IC Document

IC Title:

A Public Health Response to Trauma: Creating Conditions, Connection and Community for Women and Families

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
Other-Customer Comment Card			Attachment for OMB 0990-0379.updated 7.27.12.doc		No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	60	0	0	0	0	0
Annual IC Time Burden (Hours)	40	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Documentation	OMB Fast Track for Trauma Training 3.19.12 updated 7.27.12..docx	08/02/2012

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