Information Collection

CRCCP Annual Awardee Survey

IC 217152 under ICR 202011-0920-009 · OMB 0920-1074.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1074 can be found here:

Documents and Forms

Document Name Document Type
CRCCP Annual Awardee Survey Form and Instruction
CRCCP Annual Grantee Survey Att 4a - CRCCP Ann Awardee Srvy (screenshots) FINAL.docx Form and Instruction
CRCCP Annual Grantee Survey Att 4a - CRCCP Ann Awardee Srvy (screenshots) FINAL.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CRCCP Annual Awardee Survey	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 and Instruction	n/a	CRCCP Annual Grantee Survey	Att 4a - CRCCP Ann Awardee Srvy (screenshots) FINAL.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 35	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	9	9
Annual IC Cost Burden (Dollars)	478	478

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.