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Grantee Project Director Interview
Evaluation for the Partnerships for Success Program
OMB: 0930-0348
IC ID: 214494
OMB.report
HHS/SAMHSA
OMB 0930-0348
ICR 201501-0930-002
IC 214494
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0348 can be found here:
2016-10-03 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form Grantee Project Di
Grantee Project Director Interview
Form and Instruction
Grantee Project Di Grantee Project Director Interview
Attachment3 GranteeProjectDirInterview_8-1-2014_OMB_FINAL.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Grantee Project Director Interview
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
Form and Instruction
Grantee Project Director Interview
Grantee Project Director Interview
Attachment3 GranteeProjectDirInterview_8-1-2014_OMB_FINAL.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
30
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 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
30
0
30
0
0
0
Annual IC Time Burden (Hours)
42
0
42
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.