Monitoring State Nutrition, Physical Activity and Obesity Programs

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
State Program Interim Reporting System	Form	Modified	Available
Attachment_C_funded_states_FY2009.doc	Supplementary Document	Uploaded 2009-09-21	Available
Attachment_B 60-day FRN.pdf	Supplementary Document	Uploaded 2009-09-21	Available
Attachment_A_Authorizing_Legislation.doc	Supplementary Document	Uploaded 2009-09-21	Available
Attachment_E_Table_of_Data_Revisions_08-14-09.doc	Supplementary Document	Uploaded 2009-09-21	Available
0920-0669_SS_10 15 09.doc	Supporting Statement A	Uploaded 2009-10-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7137	State Program Interim Reporting System	Form	Modified

ICR Details

OMB Control No: 0920-0669	ICR Reference No: 200910-0920-012
Status: Historical Active	Previous ICR Reference No: 200805-0920-001
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Monitoring State Nutrition, Physical Activity and Obesity Programs
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/23/2009
	Date Received in OIRA: 10/26/2009
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2012	36 Months From Approved	06/30/2011
Responses	25	0	56
Time Burden (Hours)	250	0	672
Cost Burden (Dollars)	0	0	0

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Abstract: Information will be collected to monitor the activities conducted by awardees for "State Nutrition, Physical Activity and Obesity Programs." The program was established to prevent and control obesity by supporting States in the development and implementation of nutrition and physical activity interventions. Burden has been decreased for the current 5 year funding cycle.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 71415	12/17/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 47802	09/17/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
State Program Interim Reporting System	none	State Program Interim Reporting

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ICR Summary of Burden

table that charts list of burden

	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	25	56	0	-31	0	0
Annual Time Burden (Hours)	250	672	0	-422	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Forms

Short Statement: The program reissued its cooperative agreement in June 2008 and made minor changes. The changes necessitate adjusting the data collection instrument. We reduced the number of questions and changed to annual, vs seminannual, collection frequency. Changes to the forms are proposed and the burden estimate has decreased. The program also requests the title change to "Monitoring State Nutrition, Physical Activity and Obesity Programs."

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Annual Cost to Federal Government: $15,210

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 10/26/2009

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