Program Report Tool - Initial Population

Monitoring and Reporting System for Rape Prevention and Education (RPE) Program Awardees

Documents and Forms

Document Name Document Type
Program Report Tool - Initial Population Form
Rape Prevention and Education Program Report Tool Att._4b_Program_Report_Tool_Screenshots_041416.pdf Form
PRT (Updated) Program Report Tool Updated_Program Report Tool_OMB_No.0920-1130.docx Form
Att._4a_Program_Report_Tool_041416.docx Rape Prevention and Education Program Report Tool - word IC Document

Information Collection (IC) Details

IC Title:	Program Report Tool - Initial Population	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	none	Rape Prevention and Education Program Report Tool	Att._4b_Program_Report_Tool_Screenshots_041416.pdf		Yes	Yes	Fillable Fileable
Form	PRT	(Updated) Program Report Tool	Updated_Program Report Tool_OMB_No.0920-1130.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 18	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	18	18
Annual IC Time Burden (Hours)	144	144
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Rape Prevention and Education Program Report Tool - word	Att._4a_Program_Report_Tool_041416.docx	05/19/2016

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