Grantee program staff

ACYF Pregnancy Prevention Performance Measure Collection

Documents and Forms

Document Name Document Type
0990-ACYF_PM_Instrument 1 Perceived Impact 8-9.docx Other-survey
099-ACYF_PM Instrument 2 Reporting Form Reach 8-4.docx Other-survey
0990-PPA_PM OMB ICR Instrument 2 Reporting Form Reach revised 2 2012.docx Other-Instrument 2 Reporting Form Re
0990-PPA_PM OMB ICR Instrument 1 Perceived Impact revised 2 2012.docx Other-Instrument 1 Perceived Impact

Information Collection (IC) Details

IC Title:	Grantee program staff	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey	0990-ACYF_PM_Instrument 1 Perceived Impact 8-9.docx	Yes	Yes	Fillable Printable
Other-survey	099-ACYF_PM Instrument 2 Reporting Form Reach 8-4.docx	Yes	Yes	Fillable Printable
Other-Instrument 2 Reporting Form Reach revised 2 2012	0990-PPA_PM OMB ICR Instrument 2 Reporting Form Reach revised 2 2012.docx	Yes	Yes	Fillable Printable
Other-Instrument 1 Perceived Impact revised 2 2012	0990-PPA_PM OMB ICR Instrument 1 Perceived Impact revised 2 2012.docx	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 107	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-214	214
Annual IC Time Burden (Hours)	-856	856
Annual IC Cost Burden (Dollars)	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.