Information Collection

Public Health Law Program Needs Assessment

IC 228201 under ICR 201412-0920-011 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.