Progress Report for Injury Control Research Centers (ICRC)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Perosnnel and Publication Excel Template	Form and Instruction	New	Available
Non-CDC Study Supplement	Form and Instruction	New	Available
ICRC Indicators Data Collection	Form and Instruction	New	Available
Att 8. NCIPC Research Determination Form-ICRC.PDF	Supplementary Document	Uploaded 2017-10-13	Available
Att 7. NCIPC-CIO Privacy Act applicability.pdf	Supplementary Document	Uploaded 2017-10-13	Available
Att 6. 60DyFRN_ICRC.pdf	Supplementary Document	Uploaded 2017-10-13	Available
Att 5. ICRC indicator template guidance_08102017.docx	Supplementary Document	Uploaded 2017-10-13	Available
Att 4. Crosswalk of Indicators and Evalutation Questions.docx	Supplementary Document	Uploaded 2017-10-13	Available
Att 2. List of Grantees.docx	Supplementary Document	Uploaded 2017-10-13	Available
Att 1. Authorizing Legislation.doc	Supplementary Document	Uploaded 2017-10-13	Available
SSB_ICRC_081017_082317.docx	Supporting Statement B	Uploaded 2017-10-13	Available
SSA_ICRC_082317.docx	Supporting Statement A	Uploaded 2017-10-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
228643	Perosnnel and Publication Excel Template	Form and Instruction	New
228642	Non-CDC Study Supplement	Form and Instruction	New
228641	ICRC Indicators Data Collection	Form and Instruction	New

ICR Details

OMB Control No: 0920-1216	ICR Reference No: 201708-0920-023
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-17ND
Title: Progress Report for Injury Control Research Centers (ICRC)
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: 02/09/2018
	Date Received in OIRA: 10/24/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2021	36 Months From Approved
Responses	60	0	0
Time Burden (Hours)	500	0	0
Cost Burden (Dollars)	15,000	0	0

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Abstract: This is a new information collection request. Electronic progress reports will be collected semi-annually from 10 Injury Control Research Centers.

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Authorizing Statute(s): US Code: 42 USC 421 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:
	82 FR 10359	02/10/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 49026	10/23/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Perosnnel and Publication Excel Template	n/a	ICRC IDC Personnel and Publication Template
ICRC Indicators Data Collection	n/a	ICRC Indicators Data Collection
Non-CDC Study Supplement	n/a	ICRC IDC Non-CDC Study Supplement

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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	60	0	0	60	0	0
Annual Time Burden (Hours)	500	0	0	500	0	0
Annual Cost Burden (Dollars)	15,000	0	0	15,000	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 information collection request supporting program monitoring and evaluation.

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Annual Cost to Federal Government: $199,950

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 10/24/2017

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