WISEWOMAN Reporting System

ICR 200605-0920-006

OMB: 0920-0612

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
37802
Migrated
ICR Details
0920-0612 200605-0920-006
Historical Active 200309-0920-008
HHS/CDC
WISEWOMAN Reporting System
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 05/03/2006
Retrieve Notice of Action (NOA) 05/03/2006
  Inventory as of this Action Requested Previously Approved
11/30/2006 11/30/2006 11/30/2006
150 0 150
2,160 0 2,160
0 0 0

CDC proposes to collect comprehensive cardiovascular disease screening and intervention services data collected by grantees funded through the Well-Integrated Screening and Evaluation for Women Across the National (WISEWOMAN) program. The purpose of the data collection is to evaluate the costs and effectiveness of the program.

None
None


No

1
IC Title Form No. Form Name
WISEWOMAN Reporting System

  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 150 150 0 0 0 0
Annual Time Burden (Hours) 2,160 2,160 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
05/03/2006


© 2024 OMB.report | Privacy Policy