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Ohio Health/T.O.P.P.
Evaluation of Pregnancy Prevention Approaches - First Follow-up
OMB: 0990-0382
IC ID: 201758
OMB.report
HHS/HHSDM
OMB 0990-0382
ICR 201203-0990-004
IC 201758
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0382 can be found here:
2015-04-15 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
0990-0382Attachment B_OHIO.pdf
Other-survey
2_OhioHealth PPA FU _response to OMB_051412.docx
Other-Survey
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Ohio Health/T.O.P.P.
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
Other-Survey
2_OhioHealth PPA FU _response to OMB_051412.docx
Yes
Yes
Printable Only
Other-survey
0990-0382Attachment B_OHIO.pdf
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
170
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
510
0
510
0
0
0
Annual IC Time Burden (Hours)
357
0
357
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.