Information Collection

Att 3c_Component 3: Special Projects-Prevention, Diagnosis, and Treatment Related to the Infectious Disease Consequences of Drug Use

IC 248659 under ICR 202403-0920-014 · OMB 0920-1353.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1353 Att 3c_Component 3: Special Projects-Prevention, Diagnosis, and Treatment Related to the Infectious Disease Consequences of Drug Use	Form
0920-1353 Component 3: Special Projects—Prevention, Diagnosis, and Att 3c_Comp 3_APR_Form_rev.2024.docx	Form
0920-1353 Component 3: Special Projects—Prevention, Diagnosis, and Att 3c_Comp 3_APR_Form_rev.2024.docx	Form
Att5c_Comp 3 Instructions.docx Att 5c_Annual Performance Report—Component 3--Form Instructions Year 2 Reporting Period (10/1/21-9/30/22)	IC Document
Att5c_Comp 3 Instructions.docx Att 5c_Annual Performance Report—Component 3--Form Instructions Year 2 Reporting Period (10/1/21-9/30/22)	IC Document

IC Title:

Agency IC Tracking Number:

0920-1353

Is this a Common Form? Yes

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-1353	Component 3: Special ProjectsâPrevention, Diagnosis, and Treatment Related to the Infectious Disease Consequences of Drug Use	Att 3c_Comp 3_APR_Form_rev.2024.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

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
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	20	6	14
Annual IC Time Burden (Hours)	23	9	14
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att 5c_Annual Performance ReportâComponent 3--Form Instructions Year 2 Reporting Period (10/1/21-9/30/22)	Att5c_Comp 3 Instructions.docx	03/22/2024

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