Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Annual Performance Report New 13 130 0 Form and Instruction 0920-23AA Att. 3a APR Tool
Health Equity Capacity Assessment New 10 5 0 Form and Instruction 0920-23AA Att. 6a Health Equity Capacity Assessment Updated
Key Informant Interview Evaluator New 13 13 0 Form and Instruction 0920-23AA Att. 4b Key Informant Interview Protocol - Evaluator
Key Informant Interview – Project Lead New 13 13 0 Form and Instruction 0920-23AA Att. 4a Key Informant Interview Protocol - Project Lead
Prevention Infrastructure Assessment New 3 2 0 Form and Instruction 0920-23AA Att. 5a Prevention Infrastructure Assessment Tool Updated
Total burden requested under this ICR: 52 163 0  
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