View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0990-0452	ICR Reference No: 201606-0990-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Federal Evaluation of Making Proud Choices! (MPC!
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/17/2017
	Date Received in OIRA: 08/30/2016
Terms of Clearance: Approved consistent with the understanding that this clearance covers only the baseline survey and accompanying fidelity assessments for the overall MPC collection. Federal collection activities pertaining to the 9 and 15 month follow-up surveys will be submitted to OMB for a separate PRA review under a New/Revision ICR request.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2020	36 Months From Approved
Responses	1,493	0	0
Time Burden (Hours)	596	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	1,493	1,493
Annual Time Burden (Hours)	596	596
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: New Collection

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