Information Collection

Public Heath AmeriCorps Training and Technical Assistance Questions

IC 260703 under ICR 202503-3045-002 · OMB 3045-0137.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0137 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Public Heath AmeriCorps Training and Technical Assistance Questions Form
Form 1 Public Health AmeriCorps TTA Questions Public Heath AmeriCorps Training and Technical Assistance Questions Form
1 Public Health AmeriCorps TTA Questions PublicHealthAmeriCorps technical assistance and training form.docx www.americorps.gov Form
1 Public Health AmeriCorps TTA Questions PublicHealthAmeriCorps technical assistance and training form.docx www.americorps.gov Form
Generic Clearance Submission_PHA Evaluation_Technical Assistance and Training Form.docx Public Health AmeriCorps TTA Questions Submission Form IC Document
Generic Clearance Submission_PHA Evaluation_Technical Assistance and Training Form.docx Public Health AmeriCorps TTA Questions Submission Form IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Public Heath AmeriCorps Training and Technical Assistance Questions	Agency IC Tracking Number:

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	1	Public Health AmeriCorps TTA Questions	PublicHealthAmeriCorps technical assistance and training form.docx	www.americorps.gov	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 82	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	82	82
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Public Health AmeriCorps TTA Questions Submission Form	Generic Clearance Submission_PHA Evaluation_Technical Assistance and Training Form.docx	06/16/2023

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

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