Evaluation data for public-sector organizations

CDC Diabetes Prevention Recognition Program (DPRP)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0909 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0909 Evaluation data for public-sector organizations Form and Instruction
0920-0909 Evaluation Data Form Att 5A Data Dictionary_Evaluation Data Elements (Updated for 2018).docx Form and Instruction
Attachment 5B Evaluation Data Elements (2011).docx Data Dictionary approved 2011 IC Document
Attachment 5C Evaluation Data Submission Web Application (screenshot).docx DPRP Data Web Application IC Document

Information Collection (IC) Details

IC Title:	Evaluation data for public-sector organizations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	0920-0909	Evaluation Data Form	Att 5A Data Dictionary_Evaluation Data Elements (Updated for 2018).docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 350	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	Previously Approved
Annual Number of Responses for this IC	700	220	480
Annual IC Time Burden (Hours)	1,400	920	480
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Data Dictionary approved 2011	Attachment 5B Evaluation Data Elements (2011).docx	09/25/2014
DPRP Data Web Application	Attachment 5C Evaluation Data Submission Web Application (screenshot).docx	09/25/2014

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