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Basic Awardees Initial Budget
Monitoring and Reporting System for the State Public Health Actions Cooperative Agreements
OMB: 0920-1059
IC ID: 213710
OMB.report
HHS/CDC
OMB 0920-1059
ICR 201411-0920-001
IC 213710
( )
Documents and Forms
Document Name
Document Type
Basic Awardees Initial Budget
Form
Initial Budget
Att 4b. Budget (Basic and Enhanced).xlsx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Basic Awardees Initial Budget
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
none
Initial Budget
Att 4b. Budget (Basic and Enhanced).xlsx
Yes
Yes
Fillable Fileable
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:
6
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
6
0
6
0
0
0
Annual IC Time Burden (Hours)
24
0
24
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.