Information Collection

Youth Serving Organization (YSO) Performance Measure Reporting Tool

IC 222389 under ICR 201703-0920-010 · OMB 0920-1156.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1156 can be found here:

Documents and Forms

Document Name Document Type
Youth Serving Organization (YSO) Performance Measure Reporting Tool Form
Att 11a YSO Performance Measure Reporting Tool Online Ve Att 11a YSO Performance Measure Reporting Tool Online Version.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Youth Serving Organization (YSO) Performance Measure Reporting Tool	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	Att 11a YSO Performance Measure Reporting Tool Online Version	Att 11a YSO Performance Measure Reporting Tool Online Version.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	80	80
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.