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OWHPA Grantee Cross-Site Evaluation
Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0990-0379
IC ID: 238901
OMB.report
HHS/HHSDM
OMB 0990-0379
ICR 201708-0990-001
IC 238901
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0379 can be found here:
2024-09-11 - No material or nonsubstantive change to a currently approved collection
2024-07-08 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment A - Interview guide_Grantee_OWHPA Cross-Site_12.18.19.docx
Other-Survey Instrument- Grantee
Attachment B - Interview guide_Program Partner_OWHPA Cross-Site_12.18.19.docx
Other-Surey Instrument- Program Part
FastTrack Generic Clearance Submission- OWH Prevention Awards OWHPA Cross Site Evaluation 12-3-19.docx
OWHPA Cross-Site Evaluation FastTrack Memo
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
OWHPA Grantee Cross-Site Evaluation
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Survey Instrument- Grantee
Attachment A - Interview guide_Grantee_OWHPA Cross-Site_12.18.19.docx
No
Paper Only
Other-Surey Instrument- Program Partner
Attachment B - Interview guide_Program Partner_OWHPA Cross-Site_12.18.19.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
40
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
40
0
40
0
0
0
Annual IC Time Burden (Hours)
40
0
40
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OWHPA Cross-Site Evaluation FastTrack Memo
FastTrack Generic Clearance Submission- OWH Prevention Awards OWHPA Cross Site Evaluation 12-3-19.docx
12/12/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.