Information Collection

Community-Based Organizations Capacity Building Assistance Needs Assessment--Dually Funded CBOs funded under both PS11-1113 and PS10-1003)

IC 203574 under ICR 201208-0920-002 · OMB 0920-0948.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Community-Based Organizations Capacity Building Assistance Needs Assessment--Dually Funded CBOs funded under both PS11-1113 and PS10-1003)	Form and Instruction
Community-Based Organizations Capacity Building Assistan Att 3 CBO Assessment Tool.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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
Form and Instruction	None	Community-Based Organizations Capacity Building Assistance Needs Assessment	Att 3 CBO Assessment Tool.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 18

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	18	18
Annual IC Time Burden (Hours)	27	27
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.