Information Collection

Data Elements for All CPC Programs: Initial MIS Population for New FOA

IC 220443 under ICR 201602-0920-012 · OMB 0920-0841.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0841 can be found here:

Documents and Forms

Document Name Document Type
Data Elements for All CPC Programs: Initial MIS Population for New FOA Form and Instruction
Chronic Disease MIS: Comprehensive Cancer Control Attachment 4a. MIS screenshots for OMB_Feb.pptx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Data Elements for All CPC Programs: Initial MIS Population for New FOA	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Chronic Disease MIS: Comprehensive Cancer Control	Attachment 4a. MIS screenshots for OMB_Feb.pptx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 65	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	130	130
Annual IC Time Burden (Hours)	260	260
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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