ODPHP Partnership Engagement Survey

Prevention Communication Formative Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0281 can be found here:

Documents and Forms

Document Name Document Type
0990-0281_ODPHP E-mail Cover Letters and Reminders (5 July 2011).doc Other-cover letter
0990-0281_ Partner Engagement Survey (26 June 11 draft).docx Other-survey
0990-0281-Generic Clearance Submission#5.docx 0990-0281-Generic Clearance Submission#5 IC Document

Information Collection (IC) Details

IC Title:	ODPHP Partnership Engagement Survey	Agency IC Tracking Number:

IC Status: New

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
Other-cover letter			0990-0281_ODPHP E-mail Cover Letters and Reminders (5 July 2011).doc		Yes	No	Fillable Printable
Other-survey			0990-0281_ Partner Engagement Survey (26 June 11 draft).docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,879	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	2,879	0	0	0	0	0
Annual IC Time Burden (Hours)	480	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
0990-0281-Generic Clearance Submission#5	0990-0281-Generic Clearance Submission#5.docx	12/02/2011

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