View Information Collection (IC)

View Information Collection (IC)

IC Title:	Student Program Fidelity 8th Grade Sessions 1 - 10	Agency IC Tracking Number:

Is this a Common Form? No		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 and Instruction	HH	Student Program Fidelity 8th Grade Session 1	Atmt HH SafeDatesCompSession1.docx		No	No	Paper Only
Form and Instruction	II	Student Program Fidelity 8th Grade Session 2	Atmt II SafeDatesCompSession2.docx		No	No	Paper Only
Form and Instruction	JJ	Student Program Fidelity 8th Grade Session 3	Atmt JJ SafeDatesCompSession3.docx		No	No	Paper Only
Form and Instruction	KK	Student Program Fidelity 8th Grade Session 4	Atmt KK SafeDatesCompSession4.docx		No	No	Paper Only
Form and Instruction	LL	Student Program Fidelity 8th Grade Session 5	Atmt LL SafeDatesCompSession5.docx		No	No	Paper Only
Form and Instruction	MM	Student Program Fidelity 8th Grade Session 6	Atmt MM SafeDatesCompSession6.docx		No	No	Paper Only
Form and Instruction	NN	Student Program Fidelity 8th Grade Session 7	Atmt NN SafeDatesCompSession7.docx		No	No	Paper Only
Form and Instruction	OO	Student Program Fidelity 8th Grade Session 8	Atmt OO SafeDatesCompSession8.docx		No	No	Paper Only
Form and Instruction	PP	Student Program Fidelity 8th Grade Session 9	Atmt PP SafeDatesCompSession9.docx		No	No	Paper Only
Form and Instruction	QQ	Student Program Fidelity 8th Grade Session 10	Atmt QQ SafeDatesCompSession10.docx		No	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	800	0	0	0	0	800
Annual IC Time Burden (Hours)	200	0	0	0	0	200
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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