ASPR Temporary Reassignment Request

Information Collections to Advance State, Tribal, Local and Territorial (STLT) Governmental Agency System Performance, Capacity, and Program Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
ASPR Temporary Reassignment Request Form
ASPR Temporary Reassignment Request ASPR Attachment A - HHS Temporary Reassignment Request Form.pdf Form
ASPR Temporary Reassignment Request_Supporting Statement A.docx Supporting Statement A IC Document
ASPR Temporary Reassignment Request Form_Supporting Statement B.docx Supporting Statement B IC Document
The OKAY by OMB The Office of the Secretary request the use of 0920-0879.msg Approval from OMB to use 0920-0879 IC Document
ASPR Attachment B - Temporary Reassignment Web Site Screenshot.pdf Guidance for Temporary Reassignment IC Document
Attachment C - ASPR Final PHS Act FOA Language.docx FOA language IC Document

Information Collection (IC) Details

IC Title:	ASPR Temporary Reassignment Request	Agency IC Tracking Number:	17AY

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	ASPR Temporary Reassignment Request	ASPR Attachment A - HHS Temporary Reassignment Request Form.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	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	60	60
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A	ASPR Temporary Reassignment Request_Supporting Statement A.docx	10/18/2016
Supporting Statement B	ASPR Temporary Reassignment Request Form_Supporting Statement B.docx	10/18/2016
Approval from OMB to use 0920-0879	The OKAY by OMB The Office of the Secretary request the use of 0920-0879.msg	10/18/2016
Guidance for Temporary Reassignment	ASPR Attachment B - Temporary Reassignment Web Site Screenshot.pdf	10/18/2016
FOA language	Attachment C - ASPR Final PHS Act FOA Language.docx	10/18/2016

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