Information Collection List

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