Information Collection

Project Evaluators - Campus

IC 178434 under ICR 202311-0930-002 · OMB 0930-0286.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0286 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PSI Campus Project Evaluators - Campus	Form and Instruction
PSI Campus PSI Campus Att C.2 PSI Campus Dec2015.docx	Form and Instruction
PSI Campus PSI Campus Att C.2 PSI Campus Dec2015.docx	Form and Instruction
TASP Campus TASP Campus Att D.2 TASP Campus Dec2015.docx	Form and Instruction
TASP Campus TASP Campus Att D.2 TASP Campus Dec2015.docx	Form and Instruction
SBHF Data Abstract SBHF Data Abstraction Campus Att I. SBHF Data Abstraction (Campus) Dec2015.docx	Form and Instruction
SBHF Data Abstract SBHF Data Abstraction Campus Att I. SBHF Data Abstraction (Campus) Dec2015.docx	Form and Instruction

IC Title:

Project Evaluators - Campus

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	PSI Campus	PSI Campus	Att C.2 PSI Campus Dec2015.docx	Yes	Yes	Fillable Fileable
Form and Instruction	TASP Campus	TASP Campus	Att D.2 TASP Campus Dec2015.docx	Yes	Yes	Fillable Fileable
Form and Instruction	SBHF Data Abstraction Campus	SBHF Data Abstraction Campus	Att I. SBHF Data Abstraction (Campus) Dec2015.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-504	504
Annual IC Time Burden (Hours)	-261	261
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.