View Information Collection Request (ICR) Package

View ICR - Agency Submission

OMB Control No: 0920-1412	ICR Reference No: 202606-0920-012
Status: Received in OIRA	Previous ICR Reference No: 202507-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-26-0119
Title: [NCIPC] DELTA Achieving Health Equity through Addressing Disparities (AHEAD) COOPERATIVE AGREEMENT EVALUATION
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 06/22/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	08/31/2026
Responses	13	42
Time Burden (Hours)	130	158
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	13	42	-29
Annual Time Burden (Hours)	130	158	-28
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a revision to a previously approved collection seeking three years of approval and 130 annual burden hours.

Annual Cost to Federal Government: $44,576

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Odion Clunis 770 488-0045 lta2@cdc.gov

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.