OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Promoting Adolescent Health through School-based HIV/STD Prevention

ICR 201409-0920-004 · OMB 0920-1049 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
NGO Exemplary Sexual Health Education Measures Form New Repair queued
NGO Safe and Supportive Environment Measures Form New Repair queued
NGO Sexual Health Services Measures Form New Repair queued
Local Education Agency Exemplary Sexual Health Education Measures Form New Available
Local Education Agency Sexual Health Services Measures Form New Repair queued
Local Education Agency Safe and Supportive Environment Measures Form New Repair queued
State Education Agency Exemplary Sexual Health Education Measures Form New Available
State Education Agency Sexual Health Services Measures Form New Repair queued
State Education Agency Safe and Supportive Environment Measures Form New Repair queued
Att 11 Eval Framework.pdf Supplementary Document Uploaded 2015-01-22 Available
SS-A_OMB Clean Version.docx Supporting Statement A Uploaded 2015-01-22 Repair queued
Att 10 Analysis of Alternatives.doc Supplementary Document Uploaded 2014-09-04 Available
Att 9c SSE Rationale.pdf Supplementary Document Uploaded 2014-09-04 Available
Att 9b SHS Rationale.pdf Supplementary Document Uploaded 2014-09-04 Available
Att 9a ESHE Rationale.pdf Supplementary Document Uploaded 2014-09-04 Available
Att 7 Funded Agencies Providing Feedback.docx Supplementary Document Uploaded 2014-09-04 Repair queued
Att 6 List of Funded Agencies.docx Supplementary Document Uploaded 2014-09-04 Repair queued
Att 2 60 Day FRN.pdf Supplementary Document Uploaded 2014-09-04 Available
Att 1 Public Health Service Act Legislation.pdf Supplementary Document Uploaded 2014-09-04 Available
SSB.docx Supporting Statement B Uploaded 2015-01-22 Available
IC Document Collections
IC IDCollectionTypeStatusForm
212973 NGO Exemplary Sexual Health Education Measures Form New
212972 NGO Safe and Supportive Environment Measures Form New
212971 NGO Sexual Health Services Measures Form New
212970 Local Education Agency Exemplary Sexual Health Education Measures Form New
212969 Local Education Agency Sexual Health Services Measures Form New
212968 Local Education Agency Safe and Supportive Environment Measures Form New
212967 State Education Agency Exemplary Sexual Health Education Measures Form New
212966 State Education Agency Sexual Health Services Measures Form New
212965 State Education Agency Safe and Supportive Environment Measures Form New
ICR Details
0920-1049 201409-0920-004
Historical Active
HHS/CDC 14VU
Promoting Adolescent Health through School-based HIV/STD Prevention
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 02/03/2015
Retrieve Notice of Action (NOA) 09/23/2014
  Inventory as of this Action Requested Previously Approved
02/28/2018 36 Months From Approved
228 0 0
820 0 0
0 0 0
We request a 3-year approval for data collection using a Web-based program evaluation and monitoring system to organize, plan, and track PS13-1308 funded agency activities conducted to meet the performance and process measures established by the CDC Division of Adolescent and School Health (DASH). The system will provide access to data and reports for DASH and its funded agencies (state and local education agencies and non-governmental organizations), which allows areas for improvement to be identified and addressed. The questionnaires include performance and process measures to be used for program monitoring, evaluation, and quality improvement for HIV/STD prevention activities.
US Code: 42 USC 241 Name of Law: PHSA
  
None
Not associated with rulemaking
  79 FR 24437 04/30/2014
79 FR 53427 09/09/2014
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 228 0 0 228 0 0
Annual Time Burden (Hours) 820 0 0 820 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new ICR.
$498,851
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/23/2014