Information Collection

State and Community Awardee Training and Technical Assistance Reporting Form

IC 203976 under ICR 201409-0920-009 · OMB 0920-0952.

Documents and Forms

Document Name Document Type
Form no State and Community Awardee Training and Technical Assistance Reporting Form Form
no State and Community Awardee Training and Technical Assis Attachment 9. State and Community Awardee Training and Technical Assistance Tool.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State and Community Awardee Training and Technical Assistance Reporting Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	no	State and Community Awardee Training and Technical Assistance Reporting Form	Attachment 9. State and Community Awardee Training and Technical Assistance Tool.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	600	600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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