Grantee program staff-PREIS grantees

ACYF Pregnancy Prevention Performance Measure Collection

Documents and Forms

Document Name Document Type
0990-0392Appendix E Percieved Impact PREIS Grantees Only (3).pdf Other-evaluation
0990-0392A Attachment TPP Websystem Screenshots.pdf TPP WEBsystem Screen shot IC Document

Information Collection (IC) Details

IC Title:	Grantee program staff-PREIS grantees	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
Other-evaluation			0990-0392Appendix E Percieved Impact PREIS Grantees Only (3).pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	11	11
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
TPP WEBsystem Screen shot	0990-0392A Attachment TPP Websystem Screenshots.pdf	04/28/2015

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