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View Information Collection (IC)

View Information Collection (IC)

IC Title:	NASTAD Strengthening SSPs Evaluation: Baseline	Agency IC Tracking Number:	0920-23HS

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	NASTAD Strengthening SSPs Evaluation: Baseline	Attachment 4_NASTAD's Strengthening SSPs Baseline Survey clean final.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: 200	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	200	0	200	0	0	0
Annual IC Time Burden (Hours)	83	0	83	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
NASTAD Baseline Survey Invitation	Attachment 2_NASTAD Baseline Survey Invitation.pdf	05/02/2024
NASTAD Strengthening SSPs Evaluation: Baseline (screenshots)	Attachment 6_Screenshots of Program Evaluation for PS22-2208 Component 2 Baseline Survey.docx	05/02/2024

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