View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	[NCCDPHP] Prevention Research Centers (PRC) Program Technical Assistance Feedback Survey	Agency IC Tracking Number:	0920-1050-24AF

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	0920-24AF	TA Feedback Survey Instrument_0920-1050 GenIC	TA Feedback Survey Instrument_0920-1050 GenIC.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: 160	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	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	160	0	160	0	0	0
Annual IC Time Burden (Hours)	40	0	40	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Summary of Changes_TA Survey	Summary of Changes_TA Survey.docx	10/20/2023
REQUEST FOR APPROVAL Prevention Research Centers (PRC) Program Technical Assistance Feedback Surve	0920-1050_Customer_Service_GenIC_Technical Assistance Feedback.docx	10/23/2023

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