Information Collection

PEMS Data Collection for Community-Based Organizations (Training)

IC 180698 under ICR 200711-0920-003 · OMB 0920-0696.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0696 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PEMS Data Collection for Community-Based Organizations (Training)	Form and Instruction
PEMS Data Variables and Values for CBOs Attachment C2. PEMS 3.0 Variables for CBOs.pdf	Form and Instruction

IC Title:

PEMS Data Collection for Community-Based Organizations (Training)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	PEMS Data Variables and Values for CBOs	Attachment C2. PEMS 3.0 Variables for CBOs.pdf		Yes	Yes	Fillable Printable

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: 160

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	640	640
Annual IC Time Burden (Hours)	6,400	6,400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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