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Applicability and Use of The Community Guide Among National Association of County and City Health Officials (NACCHO) Members
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0920-0974
IC ID: 225548
OMB.report
HHS/CDC
OMB 0920-0974
ICR 201606-0920-007
IC 225548
( )
Documents and Forms
Document Name
Document Type
Applicability and Use of The Community Guide Among National Association of County and City Health Officials (NACCHO) Members
Form and Instruction
Applicability and Use of The Community Guide Among NACCH
Screenshots of NACCHO Survey 2-2-17.docx
Form and Instruction
Provide Feedback on The Community Guide invitation email script NACCHO 2-2-17.docx
Email Invitation to Participate
IC Document
Provide Feedback on The Community Guide follow-up email script NACCHO 2-2-17.docx
Email Follow-up Reminder
IC Document
Fast_Track_GenIC_Request CGB Customer feedback NACCHO 2-2-2017.docx
Template Request
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Applicability and Use of The Community Guide Among National Association of County and City Health Officials (NACCHO) Members
Agency IC Tracking Number:
0920-17PA
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 and Instruction
N/A
Applicability and Use of The Community Guide Among NACCHO Members (screenshots)
Screenshots of NACCHO Survey 2-2-17.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
300
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 New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
300
0
300
0
0
0
Annual IC Time Burden (Hours)
75
0
75
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Email Invitation to Participate
Provide Feedback on The Community Guide invitation email script NACCHO 2-2-17.docx
02/02/2017
Email Follow-up Reminder
Provide Feedback on The Community Guide follow-up email script NACCHO 2-2-17.docx
02/02/2017
Template Request
Fast_Track_GenIC_Request CGB Customer feedback NACCHO 2-2-2017.docx
02/02/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.