Information Collection

NGO Sexual Health Services Measures

IC 212971 under ICR 201710-0920-008 · OMB 0920-1049.

Documents and Forms

Document Name Document Type
NGO Sexual Health Services Measures Form
NGO SHS Measures Att 3a NGO SHS Items.docx Form
NGO - Screenshots Att 8c NGO Screenshots.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NGO Sexual Health Services Measures	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NA	NGO SHS Measures	Att 3a NGO SHS Items.docx	NA	Yes	Yes	Fillable Fileable
Form	NA	NGO - Screenshots	Att 8c NGO Screenshots.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	4	4
Annual IC Time Burden (Hours)	2	2
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.