Information Collection

Office of Adolescent Health Annual Grantee Satisfaction Survey

IC 235834 under ICR 201708-0990-001 · OMB 0990-0379.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0379 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2-Office of Adolescent Health Annual Grantee Satisfaction Survey__Scripts_Instructions_OMBCont_No._0990-0379.docx	Other-survey with instructions
1-Office of Adolescent Health Annual Grantee Satisfaction Survey_Fast Track_Memo_OMB Control No. 0990-0379.docx Office of Adolescent Health Annual Grantee Satisfaction Survey Fast track memo template	IC Document

IC Title:

Office of Adolescent Health Annual Grantee Satisfaction Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey with instructions			2-Office of Adolescent Health Annual Grantee Satisfaction Survey__Scripts_Instructions_OMBCont_No._0990-0379.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 228

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	228	228
Annual IC Time Burden (Hours)	76	76
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Office of Adolescent Health Annual Grantee Satisfaction Survey Fast track memo template	1-Office of Adolescent Health Annual Grantee Satisfaction Survey_Fast Track_Memo_OMB Control No. 0990-0379.docx	04/26/2019

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