Public Health Law Program Needs Assessment

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⚠️ Notice: This information collection may be referencing outdated material.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
Public Health Law Program Needs Assessment Form
Public Health Law Program Needs Assessment Attachment B - Instrument- Web Version.docx Form
PHLP-NA-SSA.DOCX Supporting Statement A IC Document
PHLP-NA-SSB.DOCX Supporting Statement B IC Document
Attachment A - Instrument- Word Version.docx PHLP Survey - word IC Document
Attachment C - Invitation Emails.docx Invitation Emails IC Document
Attachment D - Reminder Emails.docx Reminder Emails IC Document
Attachment E - Final Reminder Email.docx Final Reminder Email IC Document

Information Collection (IC) Details

IC Title:	Public Health Law Program Needs Assessment	Agency IC Tracking Number:	0920-0879-17BAY

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	Public Health Law Program Needs Assessment	Attachment B - Instrument- Web Version.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	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	500	500
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A	PHLP-NA-SSA.DOCX	09/06/2017
Supporting Statement B	PHLP-NA-SSB.DOCX	09/06/2017
PHLP Survey - word	Attachment A - Instrument- Word Version.docx	09/06/2017
Invitation Emails	Attachment C - Invitation Emails.docx	09/06/2017
Reminder Emails	Attachment D - Reminder Emails.docx	09/06/2017
Final Reminder Email	Attachment E - Final Reminder Email.docx	09/06/2017

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