View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	[NCIPC] Special Emphasis Panel (SEP) Peer Review Evaluation	Agency IC Tracking Number:	0920-1050-23AZ

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
Other-WORD			Att 1_FY23 Peer Review SEP Survey Evaluation Form_v.111422.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:	FR Citation:

Number of Respondents: 350	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	350	0	350	0	0	0
Annual IC Time Burden (Hours)	88	0	88	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-1050)	FY23_1050 Request Template Service Delivery_1020 (002).docx	11/14/2022
PIA	FY23 Peer Review SEP Survey_PIA.pdf	11/14/2022

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