Information Collection

Title X Grant Requirements

IC 249923 under ICR 202110-0937-005 · OMB 0937-0211.

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Information Collection (IC) Details

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IC Title:	Title X Grant Requirements	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 59

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Title X Grant Requirements	FR Citation: 86 FR 56144

Number of Respondents: 136	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	136	136
Annual IC Time Burden (Hours)	9,520	9,520
Annual IC Cost Burden (Dollars)	7,530	7,530

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