Information Collection

Princeton Center for Leadership Training /TeenPEP

IC 201762 under ICR 201502-0990-002 · OMB 0990-0382.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-0382Attachment G_TEEN PEP.pdf	Other-instrument
Instrument 5_OICA FollowUp Survey.pdf	Other-interview
0990-0382Attachment H_ Combined.pdf 0990-0382Attachment H_ Combined	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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
Other-instrument			0990-0382Attachment G_TEEN PEP.pdf		Yes	No	Printable Only
Other-interview			Instrument 5_OICA FollowUp Survey.pdf		No		Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 548

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,096	190	906
Annual IC Time Burden (Hours)	658	114	544
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0990-0382Attachment H_ Combined	0990-0382Attachment H_ Combined.pdf	03/29/2012

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