Monitoring and Reporting System for the National Tobacco Control Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Annual Budget Progress Report	Form	New	Available
Initial Population of Budget Tool	Form	New	Available
Annual Work Plan Progress Report	Form	New	Available
Initial Population of Work Plan Tool	Form	New	Available
Att 3b. Summary of Public Comments.pdf	Supplementary Document	Uploaded 2015-08-10	Available
Att 3a. FRN 6 05 2015.pdf	Supplementary Document	Uploaded 2015-08-10	Available
Att 2. Awardees.docx	Supplementary Document	Uploaded 2015-08-10	Available
SS-Part B Stat Meth 08-07-2015.docx	Supporting Statement B	Uploaded 2015-08-10	Available
SS-Part A Justification 08-07-2015.docx	Supporting Statement A	Uploaded 2015-08-10	Available
Att 1c. CSTHEA.pdf	Supplementary Document	Uploaded 2015-08-10	Available
Att 1b. PL 98-474 07-15-2014.pdf	Supplementary Document	Uploaded 2015-08-10	Available
Att 1a. PHSA 07-15-2014.pdf	Supplementary Document	Uploaded 2015-08-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
217815	Annual Budget Progress Report	Form	New
217814	Initial Population of Budget Tool	Form	New
217813	Annual Work Plan Progress Report	Form	New
217812	Initial Population of Work Plan Tool	Form	New

ICR Details

OMB Control No: 0920-1097	ICR Reference No: 201508-0920-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 15AME
Title: Monitoring and Reporting System for the National Tobacco Control Program
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/02/2016
	Date Received in OIRA: 08/19/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2019	36 Months From Approved
Responses	142	0	0
Time Burden (Hours)	445	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CDC will collect work plan and budget information from State-based tobacco control programs. Information will be used to monitor progress toward achievement of program objectives, and to support program improvement.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
   PL: Pub.L. 98 - 474 1 Name of Law: Comprehensive Smoking Education Act
   US Code: 15 USC 4401 Name of Law: Comprehensive Smokeless Tobacco Health Education Act of 1986
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 32129	06/05/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 47925	08/10/2015
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Initial Population of Budget Tool	none	National State-based Tobacco Control Programs Budget Template
Initial Population of Work Plan Tool	none	National Tobacco Control Programs Work Plan Template
Annual Budget Progress Report	none	National State-based Tobacco Control Programs Budget Template
Annual Work Plan Progress Report	none	National Tobacco Control Programs Work Plan Template

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	142	0	0	142	0	0
Annual Time Burden (Hours)	445	0	0	445	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new ICR.

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Annual Cost to Federal Government: $127,758

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/19/2015

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