Information Collection

Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Social and Community Service Managers

IC 195471 under ICR 201311-0920-017 · OMB 0920-0255.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0255 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0255 Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Social and Community Service Managers	Form and Instruction
0920-0255 Att4 Email_verification_message Att4 Email_verification_message.docx	Form and Instruction
0920-0255 Att4A_email_verification_messageTrack Att4A_email_verification_messageTrack.docx	Form and Instruction
0920-0255 Att5_email_verification_instructionsClean Att5_email_verification_instructionsClean.docx	Form and Instruction
0920-0255 Att5A_email_verification_instructionsTrack Att5A_email_verification_instructionsTrack.docx	Form and Instruction

IC Title:

Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Social and Community Service Managers

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 31 CFR 1320.3 (b) (1)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0255	Att4 Email_verification_message	Att4 Email_verification_message.docx	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0255	Att4A_email_verification_messageTrack	Att4A_email_verification_messageTrack.docx	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0255	Att5_email_verification_instructionsClean	Att5_email_verification_instructionsClean.docx	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0255	Att5A_email_verification_instructionsTrack	Att5A_email_verification_instructionsTrack.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 180

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	60	60
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.