Information Collection

Office of Adolescent Health Individual Technical Assistance Grantee Satisfaction Surveys

IC 235921 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⚠️ Notice: This information collection may be referencing outdated material.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
Office of Adolescent Health Individual Training Technical Assistance Survey 0990_0379.docx	Other-survey and instructions
1-Office of Adolescent Health Individual Training Technical Assistance Survey_Fast Track_Memo_OMB Control No. 0990-0379.docx Office of Adolescent Health Individual Technical Assistance Survey	IC Document

IC Title:

Office of Adolescent Health Individual Technical Assistance Grantee Satisfaction Surveys

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 and instructions			Office of Adolescent Health Individual Training Technical Assistance Survey 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: 15

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	15	15
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Office of Adolescent Health Individual Technical Assistance Survey	1-Office of Adolescent Health Individual Training Technical Assistance Survey_Fast Track_Memo_OMB Control No. 0990-0379.docx	05/01/2019

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