Information Collection

Program Report Tool - Annual Reporting

IC 221590 under ICR 201703-0920-012 · OMB 0920-1130.

Documents and Forms

Document Name Document Type
Program Report Tool - Annual Reporting Form
Rape Prevention and Education Program Report Tool Att._4b_Program_Report_Tool_Screenshots_041416.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Program Report Tool - Annual Reporting	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 55	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	55	55
Annual IC Time Burden (Hours)	165	165
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.