EVALUATION OF TUBERCULOSIS OUTREACH WORKER ACTIVITIES

ICR 199411-0920-002

OMB: 0920-0361

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
111099
Migrated
ICR Details
0920-0361 199411-0920-002
Historical Active
HHS/CDC
EVALUATION OF TUBERCULOSIS OUTREACH WORKER ACTIVITIES
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 02/22/1995
Retrieve Notice of Action (NOA) 11/25/1994
Approved as amended by HHS' 02/22/95 memo.
  Inventory as of this Action Requested Previously Approved
06/30/1995 06/30/1995
64 0 0
170 0 0
0 0 0

THIS SURVEY IS A NECESSARY STEP PRIOR TO DEVELOPING A PLAN TO EVALUATE THE OUTREACH ACTIVITIES OF STATE AND LOCAL TB CONTROL PROGRAMS. THE PURPOSE OF THIS PROJECT IS TO DESCRIBE THE OUTREACH ACTIVITIES AND OUTREACH WORKERS OF STATE AND LOCAL TB CONTROL PROGRAMS. THIS WILL BE ACCOMPLISHED BY CONDUCTING A MAIL SURVEY OF STATE AND LOCAL TB CONTROL PROGRAMS.

None
None


No

1
IC Title Form No. Form Name
EVALUATION OF TUBERCULOSIS OUTREACH WORKER ACTIVITIES

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 64 0 0 64 0 0
Annual Time Burden (Hours) 170 0 0 170 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/25/1994


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