NCHS Application for Vital Statistics Training Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Application for Training	Form	Modified	Available
Annual Survey of Training Needs	Form	Modified	Available
Attachment F 10-13-15.doc	Supplementary Document	Uploaded 2016-04-06	Available
Attachment E 2-10-16.pdf	Supplementary Document	Uploaded 2016-04-06	Available
Attachment D 030116.doc	Supplementary Document	Uploaded 2016-04-06	Available
Attachment A 10-13-15.docx	Supplementary Document	Uploaded 2016-04-06	Available
Supporting Statement B -040516 clean.docx	Supporting Statement B	Uploaded 2016-04-06	Available
Supporting Statement A -040516 clean.docx	Supporting Statement A	Uploaded 2016-04-06	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6685	Application for Training	Form	Modified
180101	Annual Survey of Training Needs	Form	Modified

ICR Details

OMB Control No: 0920-0217	ICR Reference No: 201604-0920-003
Status: Historical Active	Previous ICR Reference No: 201303-0920-014
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: NCHS Application for Vital Statistics Training Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/13/2016
	Date Received in OIRA: 04/13/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2019	36 Months From Approved	05/31/2016
Responses	120	0	120
Time Burden (Hours)	30	0	30
Cost Burden (Dollars)	0	0	0

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Abstract: CDC/NCHS provides free training courses to state, county, and local vital records and vital statistics staff as part of a program to promote uniformity and high quality of national vital statistics data. Approval is sought for 2 forms for individuals to apply for these training courses. The application forms are updated to capture additional logistical information.

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Authorizing Statute(s): US Code: 42 USC 242k Name of Law: Public Health Service Act
  

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 72434	11/19/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 21551	04/12/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Application for Training	none	NCH Vital Statistics Training Application
Annual Survey of Training Needs	none	Annual Survey of Training Needs

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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	120	120	0	0	0	0
Annual Time Burden (Hours)	30	30	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $10,000

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: 04/13/2016

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