Information Collection

[NCCDPHP] 2024 REACH Lark Award Challenge

IC 265996 under ICR 202306-0990-017 · OMB 0990-0390.

Documents and Forms

Document Name Document Type
Form 0990-0390 [NCCDPHP] 2024 REACH Lark Award Challenge Form and Instruction
0990-0390 2024 REACH Lark Award Challenge Application 2024 REACH Lark Award Application.docx Form and Instruction
Challenge.gov Webpage.docx Challenge.gov webpage - screenshot IC Document
NCCDPHP REACH Lark FRN_Draft_.docx Fedral Register Notice - Draft IC Document
0990-0390 HHS Challenge ICR _Mar 27 24.docx SS-A IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	[NCCDPHP] 2024 REACH Lark Award Challenge	Agency IC Tracking Number:	0990-0390

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
Form and Instruction	0990-0390	2024 REACH Lark Award Challenge Application	2024 REACH Lark Award Application.docx	N/A	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Challenge.gov webpage - screenshot	Challenge.gov Webpage.docx	03/15/2024
Fedral Register Notice - Draft	NCCDPHP REACH Lark FRN_Draft_.docx	03/15/2024
SS-A	0990-0390 HHS Challenge ICR _Mar 27 24.docx	03/27/2024

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