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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
OT18-1802: Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation's Health
Agency IC Tracking Number:
0920-1050-22CS
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
0920-1050
Survey Questionnaire
Attachment C. REDCap Survey Questions.pdf
Yes
Yes
Fillable Fileable
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:
39
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
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
39
0
39
0
0
0
Annual IC Time Burden (Hours)
6
0
6
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Recipient List
Attachment A. OT18-1802 Recipient List.pdf
02/14/2022
Survey Email Invite
Attachment B. Survey Invitation Email.pdf
02/14/2022
Survey Questionnaire Screenshots
Attachment D. REDCap Survey Screenshots_with Instructions.pdf
02/14/2022
OMB Control Header and Burden Statement
OMB Control Header and Burden Statement.docx
02/14/2022
GenIC Request Template
OT18-1802 SA_Customer Service 1050 GenIC Clearance Template_02.03.2022_final.docx
02/14/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.