View Information Collection (IC)

View Information Collection (IC)

IC Title:	Program Evaluation for Prevention Contract (PEPC)	Agency IC Tracking Number:

IC Status: New

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	PEPC3 Satisfaction Tool	PEPC3 Satisfaction Tool	3. PEPC3 Satisfaction Tool Attachment A 20220131.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Program Evaluation for Prevention Contract (PEPC)	FR Citation: 75 FR 28264

Number of Respondents: 63	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	166	0	166	0	0	0
Annual IC Time Burden (Hours)	17	0	17	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
PEPC3 Satisfaction EXPEDITED Supporting Statement _Final	2. PEPC3 Satisfaction EXPEDITED Supporting Statement _Final.docx	02/22/2022
PEPC3 Satisfaction Attachment B	4. PEPC3 Satisfaction Attachment B 20220131.docx	02/22/2022

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