Information Collection

Knowledge Application Program (KAP)

IC 228048 under ICR 201610-0930-005 · OMB 0930-0197.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0197 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Product Feedback S Knowledge Application Program (KAP)	Form and Instruction
Customer Informati Customer Information Survey Revised Attachment 1 - KAP PFS 8-23-17 092117cb.docx	Form and Instruction
Product Feedback S Product Feedback Survey Revised Attachment 2 - KAP CIS 8-23-17 092117cb.docx	Form and Instruction
Trans.Let-3-2017.doc Transmittal Letter	IC Document
KAP KAP OMB SS 8-29-17.docx Supporting Statement	IC Document

IC Title:

Knowledge Application Program (KAP)

Agency IC Tracking Number:

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 and Instruction	Product Feedback Survey	Product Feedback Survey	Revised Attachment 2 - KAP CIS 8-23-17 092117cb.docx		Yes	Yes	Fillable Fileable
Form and Instruction	Customer Information Survey	Customer Information Survey	Revised Attachment 1 - KAP PFS 8-23-17 092117cb.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

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	1,000	1,000
Annual IC Time Burden (Hours)	108	108
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Transmittal Letter	Trans.Let-3-2017.doc	08/29/2017
Supporting Statement	KAP KAP OMB SS 8-29-17.docx	08/29/2017

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