Soliciting Feedback on National Snapshot of Public Health Preparedness

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.