Assessment of the STD AAPPS Funding Program

Information Collections to Advance State, Tribal, Local and Territorial (STLT) Governmental Agency System Performance, Capacity, and Program Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
Assessment of the STD AAPPS Funding Program Form
Attachment D - Interview Guide.docx Other-Interview Guide
STD AAPPS Assessment Tool Attachment C - Instrument - Electronic Version.pdf Form
Attachment A - List of Awardee Respondents.docx List of Awardees IC Document
Attachment E - Notification Email.docx Notification Email IC Document
Attachment F - Reminder Email.docx Reminder Email IC Document
Attachment G - Extension Email.docx Follow-up Email IC Document
Attachment H Reminder Email Interview.docx Interview Reminder Email IC Document
AAPPS-SSB.docx Supporting Statement B IC Document
Attachment B - Instrument Word Version.docx Instrument - Word version IC Document
AAPPS-SSA LATEST.docx Supporting Statement A IC Document

Information Collection (IC) Details

IC Title:	Assessment of the STD AAPPS Funding Program	Agency IC Tracking Number:	17QU

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
Form	none	STD AAPPS Assessment Tool	Attachment C - Instrument - Electronic Version.pdf		Yes	Yes	Fillable Fileable
Other-Interview Guide			Attachment D - Interview Guide.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 118	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	118	118
Annual IC Time Burden (Hours)	197	197
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
List of Awardees	Attachment A - List of Awardee Respondents.docx	02/06/2017
Notification Email	Attachment E - Notification Email.docx	02/06/2017
Reminder Email	Attachment F - Reminder Email.docx	02/06/2017
Follow-up Email	Attachment G - Extension Email.docx	02/06/2017
Interview Reminder Email	Attachment H Reminder Email Interview.docx	02/06/2017
Supporting Statement B	AAPPS-SSB.docx	02/06/2017
Instrument - Word version	Attachment B - Instrument Word Version.docx	02/06/2017
Supporting Statement A	AAPPS-SSA LATEST.docx	02/06/2017

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