Information Collection

Quarterly Survey SSSP (PS22-2208)

IC 266665 under ICR 202404-0920-005 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920 Quarterly Survey SSSP (PS22-2208)	Form and Instruction
0920 Quarterly Survey SSSP (PS22-2208) Attachment 5_NASTAD's Strengthening SSPs Quarterly Survey.docx	Form and Instruction
0920 Quarterly Survey SSSP (PS22-2208) Attachment 5_NASTAD's Strengthening SSPs Quarterly Survey.docx	Form and Instruction
Attachment 3_NASTAD Quarter 1 Survey Invitation.pdf NASTAD Quarter 1 Survey Invitation	IC Document
Attachment 3_NASTAD Quarter 1 Survey Invitation.pdf NASTAD Quarter 1 Survey Invitation	IC Document
Attachment 7_Screenshots of Program Evaluation for PS22-2208 Component 2 Quarterly Survey.docx NASTAD Strengthening SSPs Evaluation: Quarterly (screenshots)	IC Document
Attachment 7_Screenshots of Program Evaluation for PS22-2208 Component 2 Quarterly Survey.docx NASTAD Strengthening SSPs Evaluation: Quarterly (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	Quarterly Survey SSSP (PS22-2208)	Attachment 5_NASTAD's Strengthening SSPs Quarterly 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	600	600
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NASTAD Quarter 1 Survey Invitation	Attachment 3_NASTAD Quarter 1 Survey Invitation.pdf	05/02/2024
NASTAD Strengthening SSPs Evaluation: Quarterly (screenshots)	Attachment 7_Screenshots of Program Evaluation for PS22-2208 Component 2 Quarterly Survey.docx	05/02/2024

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