Information Collection

OMH Minority Leadership Development Program Post-Program Questionnaires

IC 260857 under ICR 202306-0990-014 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
OMH Awardee Post-Program Questionnaire_Draft.docx	Other-Questionnaire
OMH Awardee Post-Program Questionnaire_Draft.docx	Other-Questionnaire
MLDP Host Site Agency Post Program Evaluation_Updated 5.3.docx	Other-Questionnaire
MLDP Host Site Agency Post Program Evaluation_Updated 5.3.docx	Other-Questionnaire
OMH MLDP Fellow Post Program Questionaire_5.23.docx	Other-Questionnaire
OMH MLDP Fellow Post Program Questionaire_5.23.docx	Other-Questionnaire

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire	OMH Awardee Post-Program Questionnaire_Draft.docx	Yes	Yes	Fillable Fileable
Other-Questionnaire	MLDP Host Site Agency Post Program Evaluation_Updated 5.3.docx	Yes	Yes	Fillable Fileable
Other-Questionnaire	OMH MLDP Fellow Post Program Questionaire_5.23.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.