Information Collection

ODPHP Partnership Engagement Survey

IC 200316 under ICR 200808-0990-001 · OMB 0990-0281.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

ODPHP Partnership Engagement Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

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
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 %

table that charts list of burden
	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

table that charts IC Documents
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.