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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Drug-Free Communities (DFC) Support Program National Evaluation
Agency IC Tracking Number:
3201-0012
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
1 CFR 21 § USC 1702
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
Attachment 4
Mockup of Progress Report and Core Measures Instrument
Attachment 4_Proposed Revisions_Mockup of Progress Report and Core Measures_2019_July10.docx
Yes
Yes
Fillable Fileable
Form and Instruction
Attachment 5
Coalition Classification Tool (CCT) Proposed Revisions
Attachment 5_CCT_2019_Aug6_v2.doc
Yes
Yes
Fillable Fileable
Form and Instruction
Attachment 6
Site Visit Protocols
Attachment 6_Site Visit Protocols.docx
No
Paper Only
Form and Instruction
Attachment 8
Sample Survey Review Guide
Attachment 8_Sample Survey Review Guide_10.29.18.docx
Yes
Yes
Fillable Fileable
Form and Instruction
Attachment 9
Feedback Evaluation Items
Attachment 9_Feedback Evaluation Items_10.29.18.docx
Yes
Yes
Fillable Fileable
Form and Instruction
Attachment 7
Progress Report and Core Measures - CLEAN
Attachment 7_ PR and CM Final_CleanCopy_2019_July_10.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Community and Regional Development
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,495
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,495
0
0
0
0
1,495
Annual IC Time Burden (Hours)
9,833
0
0
0
0
9,833
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment 1: Authorizations
Attachment 1_Authorization_10.29.18.pdf
09/27/2019
Attachment 2: Logic Model Evaluation Plan
Attachment 2_Logic Model Evaluation Plan_10.29.18.docx
09/27/2019
Attachment 3: Sample Evaluation Report
Attachment 3_Sample_Evaluation_Report_EndYr2017_10.29.18.pdf
09/27/2019
Attachment 10: DFC Data Sharing Request Form
Attachment 10_DFC Data Sharing Request Form_10.29.18.docx
09/27/2019
Attachment 11: Federal Registry Notices
Attachment 11_Federal Register 60Day and 30Day Notices.pdf
09/27/2019
Attachment 12: Overview of DFC Me System
Attachment 12_Overview of DFC Me system_draft_11.15.18.docx
09/27/2019
Justification Statement - DFC
1_Justification Statement_2019_Aug6.docx
09/27/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.