View Information Collection (IC)

View Information Collection (IC)

IC Title:	National Public Health Performance Standards Program State Public Health Performance Assessment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	0920-0557	NPHPSP Reporting System	NPHPSP Reporting System Version 2 - Website Screen Shots.docx		Yes	Yes	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	8	0	0	0	0	8
Annual IC Time Burden (Hours)	96	0	0	0	0	96
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Meeting Guide State	Meeting Guide - STATE 4-08.doc	07/23/2010
Data Entry Instructions	NPHPSP v2 Data Entry Instructions_1007.docx	07/23/2010
NPHPSP Denominators	NPHPSP Denominators.docx	07/23/2010
Meeting Guide Gov	Meeting Guide - GOV 4-08.doc	07/23/2010

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