Grantee Interview Protocol

Pregnancy Assistance Fund Feasibility And Design Study(Positive Adolescent Futures)

Documents and Forms

Document Name Document Type
0990-Attachment C_Interview Guide_PAF_Grantees_041514.docx Other-guide

Information Collection (IC) Details

IC Title:	Grantee Interview Protocol	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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-guide			0990-Attachment C_Interview Guide_PAF_Grantees_041514.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	7	1	6
Annual IC Time Burden (Hours)	14	2	12
Annual IC Cost Burden (Dollars)	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.