Limited Locator Form

Evaluating Locally-Developed HIV Prevention Interventions for African-American MSM in Los Angeles

OMB: 0920-0913

IC ID: 199769

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Limited Locator Form
 
No Modified
 
Voluntary
 
42 CFR 241

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Attachment 3c Limited Locator Form 6.15.11.docx Yes Yes Fillable Printable

Health Public Health Monitoring

 

700 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 700 0 0 0 0 700
Annual IC Time Burden (Hours) 58 0 0 0 0 58
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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