Information Collection

NASTAD Strengthening SSPs Evaluation: Baseline

IC 266662 under ICR 202404-0920-005 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920 NASTAD Strengthening SSPs Evaluation: Baseline	Form and Instruction
0920 NASTAD Strengthening SSPs Evaluation: Baseline Attachment 4_NASTAD's Strengthening SSPs Baseline Survey.docx	Form and Instruction
0920 NASTAD Strengthening SSPs Evaluation: Baseline Attachment 4_NASTAD's Strengthening SSPs Baseline Survey.docx	Form and Instruction
Attachment 2_NASTAD Baseline Survey Invitation.pdf NASTAD Baseline Survey Invitation	IC Document
Attachment 2_NASTAD Baseline Survey Invitation.pdf NASTAD Baseline Survey Invitation	IC Document
Attachment 6_Screenshots of Program Evaluation for PS22-2208 Component 2 Baseline Survey.docx NASTAD Strengthening SSPs Evaluation: Baseline (screenshots)	IC Document
Attachment 6_Screenshots of Program Evaluation for PS22-2208 Component 2 Baseline Survey.docx NASTAD Strengthening SSPs Evaluation: Baseline (screenshots)	IC Document

IC Title:

Agency IC Tracking Number:

0920-23HS

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920	NASTAD Strengthening SSPs Evaluation: Baseline	Attachment 4_NASTAD's Strengthening SSPs Baseline Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

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	200	200
Annual IC Time Burden (Hours)	83	83
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NASTAD Baseline Survey Invitation	Attachment 2_NASTAD Baseline Survey Invitation.pdf	05/02/2024
NASTAD Strengthening SSPs Evaluation: Baseline (screenshots)	Attachment 6_Screenshots of Program Evaluation for PS22-2208 Component 2 Baseline Survey.docx	05/02/2024

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