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

[NCCHSTP] Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments

Documents and Forms

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

Information Collection (IC) Details

IC Title:	Att 3c_Component 3: Special Projects-Prevention, Diagnosis, and Treatment Related to the Infectious Disease Consequences of Drug Use	Agency IC Tracking Number:	0920-1353

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-1353	Component 3: Special Projects—Prevention, 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 %

	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

Title	Document	Date Uploaded
Att 5c_Annual Performance Report—Component 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.