OMB control number
Community-based Organization (CBO) Monitoring and Evaluation Project (CMEP) of WILLOW (CMEP-WILLOW)
OMB 0920-0896 ยท HHS/CDC.
OMB 0920-0896
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 180-day Follow-up Survey | Form |
| 90-day Follow-up Interview | Form |
 Form 3 Baseline Survey | Form and Instruction |
| Form 1 Eligibility Screener | Form and Instruction |
| att1_PHSAsect301.pdf | Supplementary Document |
| 60-Day FRN.pdf | Supplementary Document |
 Attachment 2A_Nonsubstantive Public Comments.docx | Supplementary Document |
| SS-Part B.doc | Supporting Statement B |
| SS-Part A WILLOW rev aug 26.doc | Supporting Statement A |
 180-day Follow-up Interview--Grantee |
Instruction |
| 180-day Follow-up Survey |
Form |
| 90-day Follow-up Interview--Grantees |
Instruction |
| 90-day Follow-up Interview |
Form |
| Baseline Survey--Grantees |
Other-Screen shot |
| Baseline Survey |
Form and Instruction |
| Eligibility Screener--Grantees |
Other-screen shot |
| Eligibility Screener |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201406-0920-006 | Extension without change of a currently approved collection | 2014-06-18 | Approved with change | |
| 201108-0920-002 | New collection (Request for a new OMB Control Number) | 2011-08-09 | Approved without change |