Information Collection

User Insights for NCHHSTP Atlas Website and Tool Review _Online Survey

IC 219568 under ICR 201407-0920-003 · OMB 0920-1027.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1027 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 1_Atlas Survey Screenshots.docx	Other-Screenshots
Att 2_Atlas Invite.docx	Other-WORD
ReqforAppv_Atlas Survey_FastTrack.docx Request for Approval_Atlas Survey	IC Document

IC Title:

User Insights for NCHHSTP Atlas Website and Tool Review _Online Survey

Agency IC Tracking Number:

16JL

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-Screenshots			Att 1_Atlas Survey Screenshots.docx		Yes	Yes	Fillable Fileable
Other-WORD			Att 2_Atlas Invite.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval_Atlas Survey	ReqforAppv_Atlas Survey_FastTrack.docx	01/13/2016

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