CDC Project Officer Support: SHD Officials Assessment

Information Collections to Advance State, Tribal, Local and Territorial (STLT) Governmental Agency System Performance, Capacity, and Program Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
Attachment B - CDC-POCS Word Version of Instrument.docx Other-WORD
0920-0879 CDC Projct Oficer Effectiveness and Satisfaction Assessm Attachment C - CDC-POCS Web-based Version of Instrument.docx Form and Instruction
Attachment A - Respondent Breakdown.docx Att A_Respondent Breakdown IC Document
Attachment D - Invitation Email.docx Att D_Invitation Email IC Document
Attachment E - Reminder Email 1.docx Att E_Reminder Email 1 IC Document
Attachment F - Reminder Email 2.docx Att F_Reminder Email 2 IC Document
CDC-POCS-SSA.docx Supporting Statement A IC Document
CDC-POCS-SSB.docx Supporting Statement B IC Document

Information Collection (IC) Details

IC Title:	CDC Project Officer Support: SHD Officials Assessment	Agency IC Tracking Number:	0920-0879-20BA

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
Other-WORD			Attachment B - CDC-POCS Word Version of Instrument.docx		No		Paper Only
Form and Instruction	0920-0879	CDC Projct Oficer Effectiveness and Satisfaction Assessment: Instrument Guidance	Attachment C - CDC-POCS Web-based Version of Instrument.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 969	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
Annual Number of Responses for this IC	969	969
Annual IC Time Burden (Hours)	404	404
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att A_Respondent Breakdown	Attachment A - Respondent Breakdown.docx	10/24/2019
Att D_Invitation Email	Attachment D - Invitation Email.docx	10/24/2019
Att E_Reminder Email 1	Attachment E - Reminder Email 1.docx	10/24/2019
Att F_Reminder Email 2	Attachment F - Reminder Email 2.docx	10/24/2019
Supporting Statement A	CDC-POCS-SSA.docx	10/24/2019
Supporting Statement B	CDC-POCS-SSB.docx	10/24/2019

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