Information Collection

Soliciting Feedback on National Snapshot of Public Health Preparedness

IC 218972 under ICR 201411-0920-012 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Soliciting Feedback on National Snapshot of Public Health Preparedness	Form
PHEP Directors' Survey Att1-PHEPDirSur.docx	Form
Soliciting Feedback on Annual Preparedness Report-GenIC Clearance Template_HW_v1.docx Request for Approval	IC Document

IC Title:

Soliciting Feedback on National Snapshot of Public Health Preparedness

Agency IC Tracking Number:

16EK

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
Form	none	PHEP Directors' Survey	Att1-PHEPDirSur.docx		Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 62

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	62	62
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	Soliciting Feedback on Annual Preparedness Report-GenIC Clearance Template_HW_v1.docx	11/13/2015

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