OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Evaluation of Adolescent Pregnancy Prevention Approaches Household (Modified PPA) Survey

IC 199830 under ICR 201110-0990-004 · OMB 0990-0389.

Documents and Forms
Document Name
Document Type
Other-survey
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Evaluation of Adolescent Pregnancy Prevention Approaches Household (Modified PPA) Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-survey 0990-TPP Evaluation Attachment C_Baseline Instrument.docx Yes Yes Fillable Printable

Health Illness Prevention

 

6,000 0
   
Individuals or Households
 
   0 %

  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 6,000 0 6,000 0 0 0
Annual IC Time Burden (Hours) 4,500 0 4,500 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
0990-TPP evaluation Attachment F_young adult consent 0990-TPP evaluation Attachment F_young adult consent.docx 10/21/2011
0990-TPP evaluation Attachment G_household notification 0990-TPP evaluation Attachment G_household notification.docx 10/21/2011
0990-TPP evaluation Attachment E_youth assent 0990-TPP evaluation Attachment E_youth assent.docx 10/21/2011
0990-TPP evaluation Attachment D_parental consent 0990-TPP evaluation Attachment D_parental consent.docx 10/21/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.