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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
SSG Fox SPGP - Annual Grantee Financial Report
New
90
68
0
Form and Instruction
10-316e
SSG Fox SPGP - Annual Grantee Financial Report
SSG Fox SPGP - Annual Grantee Performance Report
New
90
68
0
Form
10-316a
SSG Fox SPGP - Annual Grantee Performance Report
SSG Fox SPGP - Application
New
250
8750
0
Form and Instruction
10-315a
SSG Fox SPGP - Application
SSG Fox SPGP - Columbia Suicide Risk Screening (CSSRS)
New
6030
1508
0
Other-Screening Tool
SSG Fox SPGP - Corrective Action Plan (CAP)
New
25
13
0
Form and Instruction
10-316d
SSG Fox SPGP - Corrective Action Plan (CAP)
SSG Fox SPGP - Eligibility Screening
New
6030
3015
0
Form
10-317a
SSG Fox SPGP - Eligibility Screening Form
SSG Fox SPGP - Intake Form & Assessments
New
6030
3015
0
Form and Instruction
10-317b
SSG Fox SPGP - Intake Form & Assessments
SSG Fox SPGP - Other Grantee Performance Report
New
180
90
0
Form
10-316b
SSG Fox SPGP - Other Grantee Performance Report
SSG Fox SPGP - Participant Satisfaction Survey
New
5000
1250
0
Form
10-317c
SSG Fox SPGP - Participant Satisfaction Survey
SSG Fox SPGP - Program Change Request
New
180
45
0
Form
10-316c
SSG Fox SPGP - Program Change Request
SSG Fox SPGP - Program Exit Checklist & Assessments
New
6030
3015
0
Form
10-317d
SSG Fox SPGP - Program Exit Checklist & Assessments
SSG Fox SPGP - Quarterly Grantee Financial Report
New
180
90
0
Form and Instruction
10-316f
SSG Fox SPGP - Quarterly Grantee Financial Report
SSG Fox SPGP - Renewal Application
New
90
900
0
Form and Instruction
10-315b
SSG Fox SPGP - Renewal Application
Total burden requested under this ICR:
30205
21827
0
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