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National Public Health Performance Standards Program Local Public Health Governance Performance Assessment Tool
National Public Health Performance Standards Program Local Public Health Governance Performance Assessment Tool
OMB: 0920-0580
IC ID: 7041
OMB.report
HHS/CDC
OMB 0920-0580
ICR 201008-0920-006
IC 7041
( )
Documents and Forms
Document Name
Document Type
Attachment E Govt booklet C.pdf
Instruction
Attachment E Govt booklet A.pdf
Instruction
Attachment E Govt booklet B.pdf
Instruction
Attachment F Meeting Guide.doc
Attachment F Meeting Guide
IC Document
Attachment G NPHPSP Data Entry Instructions.doc
Attachment G Data Enty Instructions
IC Document
Attachment H NPHPSP Reporting System Website Screen Shots.doc
Attachment H Web Screen Shots
IC Document
NPHPSP Denominator .xls
Attachment D Possible Respondents
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Public Health Performance Standards Program Local Public Health Governance Performance Assessment Tool
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Instruction
Attachment E Govt booklet C.pdf
Yes
Yes
Fillable Printable
Instruction
Attachment E Govt booklet A.pdf
Yes
Yes
Fillable Printable
Instruction
Attachment E Govt booklet B.pdf
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
175
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
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
175
0
0
0
0
175
Annual IC Time Burden (Hours)
875
0
0
0
0
875
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment F Meeting Guide
Attachment F Meeting Guide.doc
07/27/2010
Attachment G Data Enty Instructions
Attachment G NPHPSP Data Entry Instructions.doc
07/27/2010
Attachment H Web Screen Shots
Attachment H NPHPSP Reporting System Website Screen Shots.doc
07/27/2010
Attachment D Possible Respondents
NPHPSP Denominator .xls
07/27/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.