Post-Test Treatment Across the Lifespan

Improving Fetal Alcohol Spectrum Disorders Prevention and Practice through Practice and Implementation Centers and National Partnerships

Documents and Forms

Document Name Document Type
Form 0292-1129 Post-Test Treatment Across the Lifespan Form and Instruction
0292-1129 B14 Post-Test Treatment Across Lifespan B14 Post-Test Treatment Across Lifespan.docx Form and Instruction
0292-1129 B14 Post-Test Treatment Across Lifespan B14 Post-Test Treatment Across Lifespan.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Post-Test Treatment Across the Lifespan	Agency IC Tracking Number:	0920-1129

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 241

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0292-1129	B14 Post-Test Treatment Across Lifespan	B14 Post-Test Treatment Across Lifespan.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	14	14
Annual IC Cost Burden (Dollars)	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.