Interview Eligibility Screener Category 1

Community-based Organization Outcome Monitoring Projects for CBO HIV Prevention Services Clients

OMB: 0920-1172

IC ID: 223228

Information Collection (IC) Details

View Information Collection (IC)

Interview Eligibility Screener Category 1
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Eligibility Screener Att3a PI EligibScreenCat1.docx No   Paper Only

Health Public Health Monitoring

 

175 0
   
Individuals or Households
 
   0 %

  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 175 0 175 0 0 0
Annual IC Time Burden (Hours) 9 0 9 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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