OMB
.report
Search
Office of Population Affairs (OPA) Title X Grantee Needs Assessment Survey
Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0990-0379
IC ID: 241507
OMB.report
HHS/HHSDM
OMB 0990-0379
ICR 201708-0990-001
IC 241507
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0379 can be found here:
2024-07-08 - No material or nonsubstantive change to a currently approved collection
2024-02-28 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
1-Office of Population Affairs Title X Grantee Needs Assessment Surveys_PRA Form OMB Control No. 0990-0379_FINAL (002).docx
Other-needs assessment survey with s
1-Office of Population Affairs Title X Grantee Needs Assessment Surveys_PRA Form OMB Control No. 0990-0379_FINAL (002).docx
Office Population Affairs Title X Grantee Needs Assessment Fast track memo
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Office of Population Affairs (OPA) Title X Grantee Needs Assessment Survey
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-needs assessment survey with scripts and instructions
1-Office of Population Affairs Title X Grantee Needs Assessment Surveys_PRA Form OMB Control No. 0990-0379_FINAL (002).docx
Yes
Yes
Fillable Fileable
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:
1,680
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
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
1,680
0
1,680
0
0
0
Annual IC Time Burden (Hours)
420
0
420
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Office Population Affairs Title X Grantee Needs Assessment Fast track memo
1-Office of Population Affairs Title X Grantee Needs Assessment Surveys_PRA Form OMB Control No. 0990-0379_FINAL (002).docx
04/23/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.