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NGO Sexual Health Services Measures
Promoting Adolescent Health through School-based HIV/STD Prevention
OMB: 0920-1049
IC ID: 212971
OMB.report
HHS/CDC
OMB 0920-1049
ICR 201710-0920-008
IC 212971
( )
Documents and Forms
Document Name
Document Type
NGO Sexual Health Services Measures
Form
NGO SHS Measures
Att 3a NGO SHS Items.docx
Form
NGO - Screenshots
Att 8c NGO Screenshots.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NGO Sexual Health Services Measures
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
NA
NGO SHS Measures
Att 3a NGO SHS Items.docx
NA
Yes
Yes
Fillable Fileable
Form
NA
NGO - Screenshots
Att 8c NGO Screenshots.docx
NA
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2
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
4
0
0
0
0
4
Annual IC Time Burden (Hours)
2
0
0
0
0
2
Annual IC Cost Burden (Dollars)
0
0
0
0
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.